Provider Demographics
NPI:1376859876
Name:KYM, SARAH ELYSSE (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELYSSE
Last Name:KYM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUNG
Other - Middle Name:EUN
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:700 E MOREHEAD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 CARNIE BLVD STE B5
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4514
Practice Address - Country:US
Practice Address - Phone:888-909-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2085R0202X2085R0202X
NV158602085R0202X
NJ25MA125310002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology