Kim, Samang O

Kim, Samang O is an individual health care provider with primary practice located at 2016 S Main St , Maryville MO 64468-2655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kim, Samang O can be contacted via phone (660) 562-7991.

Contact Information

Primary practice address
2016 S Main St Maryville MO 64468-2655
Phone: (660) 562-7991
Fax: (660) 562-7992
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 119789 Missouri

Profile Details

NPI number 1750309142
LBN Legal business name Kim, Samang O
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated May 17th, 2024 - about 6 months 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 1750309142 NPPES
Missouri MEDICAID 244759320

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