| Sangae Kim-park, Md, Pc | |
|
52 Medical Park Dr E Suite 312 Birmingham AL 35235-3430 | |
| (205) 702-6602 | |
| (205) 836-3190 |
| Full Name | Sangae Kim-park, Md, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 52 Medical Park Dr E, Birmingham, Alabama |
| Authorized Official Name and Position | Chulwon Park (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2057026602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sangae Kim-park, Md, Pc 52 Medical Park Dr E Suite 312 Birmingham AL 35235-3430 Ph: (205) 702-6602 | Sangae Kim-park, Md, Pc 52 Medical Park Dr E Suite 312 Birmingham AL 35235-3430 Ph: (205) 702-6602 |
| NPI Number | 1053508200 |
|---|---|
| Provider Enumeration Date | 10/02/2007 |
| Last Update Date | 10/08/2019 |
| Medicare PECOS PAC ID | 6608956016 |
|---|---|
| Medicare Enrollment ID | O20080110000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053508200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 28332 (Alabama) | Primary |
| Provider Name | Sangae Kim-park |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760679351 PECOS PAC ID: 4789764192 Enrollment ID: I20080110000128 |
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