DR. SANG WON DACRI-KIM (NPI# 1043385529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043385529 |
| Entity Type | Individual |
| Full Name | DR. SANG WON DACRI-KIM |
| Credential | DO |
| Practice Address |
1970 Tamarack Rd. Newark OH 43055 |
| Practice Telephone | 7403442452 |
| Practice Fax Number | 7405227305 |
| Mailing Telephone | 7403442452 |
| Mailing Fax Number | 7405227305 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2010-11-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 34006602 | OH | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
34006602 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2028577 | 05 | |
| OH | RAILROAD MEDICARE | P00397004 | 01 |
| Street Address |
1970 TAMARACK RD. |
| City | NEWARK |
| State | OH |
| Zip Code | 43055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770125585 | Jessica Danielle Dunkle | Case Manager/Care Coordinator | 15 N 3rd Street Suite 300, Newark, OH 43055 | 2019-10-14 |
| 1558910331 | Diana Cleland | Home Health Aide | 25 Western Rd, Apartment A, Newark, OH 43055 | 2019-09-05 |
| 1912424789 | Sandra Lou Fraley | Community/Behavioral Health | 15 North 3rd Street, Suite 300, Newark, OH 43055 | 2017-08-23 |
| 1215450911 | Caitlyn Thella Smith Elkins | Social Worker | 15 N. 3rd St., Newark, OH 43055 | 2017-07-25 |
| 1992227888 | Sierra Elizabeth Donley | Student in an Organized Health Care Education/Training Program | 140 W Church St, Newark, OH 43055 | 2017-07-12 |
| 1386170587 | Patricia Louise Fischer | Pharmacist | 1155 North 21rst Street, Newark, OH 43055 | 2017-05-08 |
| 1689120958 | Bebout Services, LLC | Home Health | 1325 Dayton Road Ne, Newark, OH 43055 | 2016-08-28 |
| 1750834594 | Laura Smith | Registered Nurse | 1445 West Main Street, Suite B, Newark, OH 43055 | 2016-07-28 |
| 1164807277 | Frank Kobe | Psychologist | 116 N. 21st Street, Newark, OH 43055 | 2015-07-30 |
| 1770975898 | Gentle Foot Care, Inc | Podiatrist | 1271 W Main Street, Bldg 1, Newark, OH 43055 | 2015-02-26 |
| Find all providers in zip 43055 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437415684 | Reid A Ravin | Surgery | 4755 Ogletown Stanton Rd Ste 1e20, Newark, DE 19718-2200 | 2012-04-02 |
| 1932276755 | Zafar Jamil | Surgery | 306 Dr Martin Luther King Jr Blvd, Newark, NJ 07102-2011 | 2006-11-29 |
| 1992818421 | Thomas K Evans | Surgery | 1 Centurian Dr Ste 307, Newark, DE 19713 | 2006-08-17 |
| 1356343586 | William H Phillips | Surgery | 1371 West Main Street, Newark, OH 43055 | 2005-06-01 |
| 1427306240 | Delaware Vascular and Vein Center, LLC | Surgery | 774 Christiana Rd, Suite 109, Newark, DE 19713-4236 | 2012-08-28 |
| 1366716060 | Vascular Specialists, P.a. | Surgery | 1 Centurian Dr, Suite 307, Newark, DE 19713-2137 | 2012-02-28 |
| 1689984940 | Asclepius Vascular Services PC | Surgery | 111 Central Avenue, Newark, NJ 07102 | 2010-10-20 |
| 1083858872 | Joe T. Huang | Surgery | 150 Bergen St, F-102, Newark, NJ 07103-2496 | 2009-04-24 |
| 1043379290 | Delaware Vascular Associates P A | Surgery | 4735 Ogletown Stanton Rd, Medical Arts Pavilion 2 Suite 1208, Newark, DE 19713-2072 | 2006-12-06 |
| 1821101312 | Frederic Todd Harad | Surgery | 4735 Ogletown Stanton Road, Suite 1e20, Newark, DE 19713 | 2006-08-17 |
| Find all providers in NEWARK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.