Provider Demographics
NPI:1437175916
Name:KIM, ROSE (MD)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 513 (INFECTIOUS DISEASE)
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-963-3715
Practice Address - Fax:856-635-1052
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA080680207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
01077778400OtherAMERICHOICE
1297027OtherAETNA US HEALTHCARE
NJ0109614Medicaid
60025900OtherHIRIZON NJ HEALTH
3K6106OtherHEALTHNET
43500OtherUNIVERSITY HEALTH PLAN
8897387OtherCIGNA
P3722698OtherOXFORD HELATH PAN
2739748000OtherAMERIHEALTH HMO, KEYSTONE, IBC
2633237OtherUNITED HEALTH PLAN
43500OtherUNIVERSITY HEALTH PLAN