| Lisa M Kim M D Inc | |
|
3355 Rogers Ave Ellicott City MD 21043-4105 | |
| (410) 480-5195 | |
| (410) 480-5197 |
| Full Name | Lisa M Kim M D Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3355 Rogers Ave, Ellicott City, Maryland |
| Authorized Official Name and Position | Lisa M Kim (OWNER) |
| Authorized Official Contact | 4104805195 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa M Kim M D Inc 3355 Rogers Ave Ellicott City MD 21043-4105 Ph: (410) 480-5195 | Lisa M Kim M D Inc 3355 Rogers Ave Ellicott City MD 21043-4105 Ph: (410) 480-5195 |
| NPI Number | 1457660110 |
|---|---|
| Provider Enumeration Date | 09/29/2010 |
| Last Update Date | 09/29/2010 |
| Medicare PECOS PAC ID | 8123212099 |
|---|---|
| Medicare Enrollment ID | O20101104000704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457660110 | NPI | - | NPPES |
| 346603500 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | D52479 (Maryland) | Primary |
| Provider Name | Lisa M Kim |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1982795753 PECOS PAC ID: 6800080771 Enrollment ID: I20101104000796 |
Cecilia Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3219 Corporate Ct, Ellicott City, MD 21042 Phone: 443-929-1462 | |
Graceway Health Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10259 Cabery Rd, Ellicott City, MD 21042 Phone: 667-300-8222 | |
Jeffrey R. Kaplan M.d. Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5116 Dorsey Hall Dr Ste A, Ellicott City, MD 21042 Phone: 410-964-9300 Fax: 410-964-9822 | |
Ellicott City Primary Care Medicine Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10298b Baltimore National Pike, Ellicott City, MD 21042 Phone: 410-465-1091 Fax: 410-465-8129 | |
Integrative Health Practices, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9501 Old Annapolis Rd Ste 205, Ellicott City, MD 21042 Phone: 410-715-5256 | |
Pp And M Ventures Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3219 Corporate Ct, Ellicott City, MD 21042 Phone: 410-701-8485 | |
Privia Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9055 Chevrolet Dr Ste 100, Ellicott City, MD 21042 Phone: 410-465-5454 |