| Organization Name: | HOLMDEL MEDICAL GROUP, INC |
| NPI Number: | 1114962297 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHONG S KIM (PRESIDENT) |
| Mailing Address: | 100 Commons Way Suite 701 Holmdel |
| State: | NJ US |
| Postal Code: | 077332934 |
| Phone Number: | 7327960182 |
| Fax Number: | |
| NPI Enumeration Date: | 06/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207YX0905X |
| License Number: | MA72196 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Otolaryngology |
| Taxonomy Specialization: | Otolaryngology/Facial Plastic Surgery |
| Taxonomy Definition: | An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |