Kim, Sam Y

Kim, Sam Y is an individual health care provider with primary practice located at 1919 Lathrop St Ste 103, Fairbanks AK 99701-5937. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Kim, Sam Y can be contacted via phone (907) 456-7768.

Contact Information

Primary practice address
1919 Lathrop St Ste 103 Fairbanks AK 99701-5937
Phone: (907) 456-7768
Fax: (907) 456-4045
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 5779 Alaska
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 01051686A Indiana
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X A99387 California

Profile Details

NPI number 1851454615
LBN Legal business name Kim, Sam Y
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2006
Last updated Apr 1st, 2016 - about 9 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 1851454615 NPPES
Alaska MEDICAID MD0304

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