Provider Demographics
NPI:1285889444
Name:KIM, GEORGE R (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:R
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3501 SAINT PAUL ST
Mailing Address - Street 2:729
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2703
Mailing Address - Country:US
Mailing Address - Phone:410-243-0413
Mailing Address - Fax:410-955-4582
Practice Address - Street 1:3501 SAINT PAUL ST
Practice Address - Street 2:729
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2703
Practice Address - Country:US
Practice Address - Phone:410-243-0413
Practice Address - Fax:410-955-4582
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD36832208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics