Provider Demographics
NPI:1003893116
Name:KIM, YOON JUNG (MD)
Entity Type:Individual
Prefix:
First Name:YOON
Middle Name:JUNG
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9114 PHILADELPHIA RD SUITE 108
Mailing Address - Street 2:STE 108, MEDICAL HEALTH GROUP AT WHITE MARSH
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4317
Mailing Address - Country:US
Mailing Address - Phone:410-918-0777
Mailing Address - Fax:410-369-1707
Practice Address - Street 1:9114 PHILADELPHIA RD SUITE 108
Practice Address - Street 2:STE 108, MEDICAL HEALTH GROUP AT WHITE MARSH
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4317
Practice Address - Country:US
Practice Address - Phone:410-918-0777
Practice Address - Fax:410-369-1707
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2009-12-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0047157207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2331600OtherAETNA HMO
W6470007OtherBLUE CHOICE
P15186OtherMPOS
5816355OtherPPO
P15186OtherMPOS
W6470007OtherBLUE CHOICE