Provider Demographics
NPI:1578574414
Name:KIM, DUK HEE (MD)
Entity Type:Individual
Prefix:
First Name:DUK
Middle Name:HEE
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 CHRIS GAUPP DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205
Mailing Address - Country:US
Mailing Address - Phone:609-748-5015
Mailing Address - Fax:609-748-0303
Practice Address - Street 1:408 CHRIS GAUPP DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205
Practice Address - Country:US
Practice Address - Phone:609-748-5015
Practice Address - Fax:609-748-0303
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07092300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8593906Medicaid
NJ8593906Medicaid
H28441Medicare UPIN