Provider Demographics
NPI:1841237179
Name:KIM, SUN YEONG (MD)
Entity Type:Individual
Prefix:DR
First Name:SUN
Middle Name:YEONG
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 1:214 SIMMONS RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-9512
Mailing Address - Country:US
Mailing Address - Phone:717-245-5700
Mailing Address - Fax:
Practice Address - Street 1:45 SPRINT DR
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-7696
Practice Address - Country:US
Practice Address - Phone:717-245-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072021L207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014235500001Medicaid
H48999Medicare UPIN
PA1014235500001Medicaid