Kim, Susie C

Kim, Susie C is an individual health care provider with primary practice located at 1 Mercado St Ste 130, Durango CO 81301-7306. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Kim, Susie C can be contacted via phone (970) 247-1120.

Contact Information

Primary practice address
1 Mercado St Ste 130 Durango CO 81301-7306
Phone: (970) 247-1120
Fax: (970) 247-1128
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 41867 Colorado
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 41867 Colorado

Profile Details

NPI number 1548258379
LBN Legal business name Kim, Susie C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Sep 30th, 2022 - about 4 years 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 1548258379 NPPES
Nebraska MEDICAID 1982948089
Nebraska MEDICAID 10026280800
Nebraska MEDICAID 10026280600
Nebraska MEDICAID 10026281000
Nebraska MEDICAID 201038550A
Nebraska MEDICAID 57723834
Nebraska MEDICAID 10026280700
Nebraska MEDICAID 10026281200
Nebraska MEDICAID 10026283100

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