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Myung-sup Kim Md Pa
Specialist in Petersburg, West Virginia
NPI 1457311656

Myung-sup Kim Md Pa is a Specialist based in Cumberland, WV. Myung-sup Kim Md Pa practices in Petersburg, WV. The NPI Number for Myung-sup Kim Md Pa is 1457311656 and holds a License No. (West Virginia).

The current practice location address for Myung-sup Kim Md Pa is Rt 55 West, Petersburg, WV and can be reached out via phone at 304-257-1026.

Location: Rt 55 West, Petersburg, WV, 21501-0240
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1457311656
Provider Name
Myung-sup Kim Md Pa
Credential
Provider Entity Type
Organization
Address
Rt 55 West, Petersburg, WV, 21501-0240
Phone Number
304-257-1026
Fax Number
Provider Enumeration Date
03/23/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3810011406 05 WV
991702100 05 MD
S366 01 MD FEDERAL BS
02059300 01 BLACK LUNG
001708869 01 WV BLUE SHIELD
1120362 01 MAMSI
KCD4 01 MD BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
Rt 55 West
City
Petersburg
State
West Virginia
Zip
26847
Phone Number
304-257-1026
Fax Number
person
Provider Business Mailing Address Details
Address
Rt 55 West
City
Petersburg
State
West Virginia
Zip
26847
Phone Number
304-257-1026
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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