Provider Demographics
NPI:1255505541
Name:SLOAN, KIM WRIGHT (MD)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:WRIGHT
Last Name:SLOAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1000 MORRIS AVE
Mailing Address - Street 2:KEAN UNIV D'ANGOLA GYM #103
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7133
Mailing Address - Country:US
Mailing Address - Phone:908-737-5520
Mailing Address - Fax:908-737-5525
Practice Address - Street 1:1000 MORRIS AVE
Practice Address - Street 2:KEAN UNIV D'ANGOLA GYM #103
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7133
Practice Address - Country:US
Practice Address - Phone:908-737-5520
Practice Address - Fax:908-737-5525
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-07-30
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Provider Licenses
StateLicense IDTaxonomies
NJMA32112207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC52436Medicare UPIN