Provider Demographics
NPI:1508840737
Name:MAY, KIM WEEMS (MD)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:WEEMS
Last Name:MAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2415 N 33RD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-2804
Mailing Address - Country:US
Mailing Address - Phone:215-225-6222
Mailing Address - Fax:215-225-6224
Practice Address - Street 1:2415 N 33RD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-2804
Practice Address - Country:US
Practice Address - Phone:215-225-6222
Practice Address - Fax:215-225-6224
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD068323L207R00000X
PAMD-068323-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0641791000OtherINDEPENDENCE BLUE CROSS
PA10514OtherBRAVO HEALTH
PA2120476OtherMAMSI LIFE & HEALTH
PA764747OtherHIGHMARK BLUE SHIELD
PA110243303OtherRAIL ROAD MEDICARE
PA447792OtherCOVENTRY HEALTH AMERICA
PA001741580Medicaid
PA3002618OtherAETNA HMO
PA5021769OtherAETNA PPO
PA30009544OtherKEYSTONE MERCY HEALTH PLA
PA5021769OtherAETNA PPO
PA447792OtherCOVENTRY HEALTH AMERICA
PAH05250Medicare UPIN