Provider Demographics
NPI:1396739439
Name:SHIM, CHRISTINE MIMI (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MIMI
Last Name:SHIM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2645 N FEDERAL HWY
Mailing Address - Street 2:STE 120
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-6100
Mailing Address - Country:US
Mailing Address - Phone:561-740-2004
Mailing Address - Fax:561-880-8260
Practice Address - Street 1:2645 N FEDERAL HWY
Practice Address - Street 2:STE 120
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-6100
Practice Address - Country:US
Practice Address - Phone:561-740-2004
Practice Address - Fax:561-880-8260
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-05
Last Update Date:2016-11-29
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Provider Licenses
StateLicense IDTaxonomies
FLME79337207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH20097Medicare UPIN
FL35822Medicare PIN