Provider Demographics
NPI:1760887145
Name:KIM, JOONMIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOONMIN
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8155 CYPRUS CEDAR LN
Mailing Address - Street 2:F
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-5534
Mailing Address - Country:US
Mailing Address - Phone:443-527-0409
Mailing Address - Fax:
Practice Address - Street 1:1001 YORK RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2516
Practice Address - Country:US
Practice Address - Phone:410-823-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist