| Soo R Kim Md Pc | |
|
29 West Oneida St Oswego NY 13126 | |
| (315) 343-5970 | |
| (315) 343-3739 |
| Full Name | Soo R Kim Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 29 West Oneida St, Oswego, New York |
| Authorized Official Name and Position | Soo R Kim (OWNER) |
| Authorized Official Contact | 3153435970 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soo R Kim Md Pc 29 West Oneida St Oswego NY 13126 Ph: (315) 343-5970 | Soo R Kim Md Pc 29 West Oneida St Oswego NY 13126 Ph: (315) 343-5970 |
| NPI Number | 1730204421 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 04/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730204421 | NPI | - | NPPES |
| 1851475958 | Other | CURRENT NPI# | |
| 00758076 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 149942 (New York) | Primary |
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