Provider Demographics
NPI:1215228846
Name:KIM, JANE (MD)
Entity Type:Individual
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First Name:JANE
Middle Name:
Last Name:KIM
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Gender:F
Credentials:MD
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Mailing Address - Street 1:22 S GREENE ST
Mailing Address - Street 2:UNIV OF MARYLAND MED CENTER - DEPT OF RADIOLOGY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1544
Mailing Address - Country:US
Mailing Address - Phone:410-328-3477
Mailing Address - Fax:410-328-0641
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:UNIV OF MARYLAND MED CENTER - DEPT OF RADIOLOGY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-3477
Practice Address - Fax:410-328-0641
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-01
Last Update Date:2017-02-23
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Provider Licenses
StateLicense IDTaxonomies
CAA1412772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology