Provider Demographics
NPI:1750373890
Name:KIM, HYUN J (MD)
Entity type:Individual
Prefix:
First Name:HYUN
Middle Name:J
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1417 MADISON PARK DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5613
Mailing Address - Country:US
Mailing Address - Phone:410-768-6600
Mailing Address - Fax:410-768-3132
Practice Address - Street 1:1417 MADISON PARK DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5613
Practice Address - Country:US
Practice Address - Phone:410-768-6600
Practice Address - Fax:410-768-3132
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2012-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD34480207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD060017114OtherRAILROAD MEDICARE
MD434131700Medicaid
MD434131700Medicaid
MD060017114OtherRAILROAD MEDICARE