Kim, Doo Tae

Kim, Doo Tae is an individual health care provider with primary practice located at 250 S 21St St , Easton PA 18042-3851. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Kim, Doo Tae can be contacted via phone (610) 250-4303.

Contact Information

Primary practice address
250 S 21St St Easton PA 18042-3851
Phone: (610) 250-4303
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD-034047-L Pennsylvania

Profile Details

NPI number 1285638056
LBN Legal business name Kim, Doo Tae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285638056 NPPES
Pennsylvania MEDICAID 0647583

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