Kim, Jin Tae

Kim, Jin Tae is an individual health care provider with primary practice located at 1250 E Marshall St Radiology, Richmond VA 23298-5051. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Kim, Jin Tae can be contacted via phone (804) 628-3580.

Contact Information

Primary practice address
1250 E Marshall St Radiology Richmond VA 23298-5051
Phone: (804) 628-3580
Fax: (804) 628-3593
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X A73178 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X M5291 Texas
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 0101245471 Virginia

Profile Details

NPI number 1689791493
LBN Legal business name Kim, Jin Tae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2007
Last updated Jul 22nd, 2011 - about 13 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 1689791493 NPPES
Texas MEDICAID 195889402
Texas Other 8BC330
Texas Other 195889403

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