Kimberly Dawn Gum, PHARM.D.
Individual provider Active NPI Pharmacist · Elkview, WV
NPI 1821489923 · NPPES record last updated Feb 10, 2015
Key facts
- NPI
- 1821489923
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP0005971 (WV)
- Practice address
- 64 Maddys LN
Elkview, WV 25071-9684 - Phone
- (304) 935-4464
- NPI assigned
- Feb 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP0005971 | WV | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP0005971 | WV | Yes |
Addresses
Primary practice location
64 Maddys LN
Elkview, WV 25071-9684
Mailing address
64 Maddys LN
Elkview, WV 25071-9684
Phone (304) 935-4464
Other providers in Elkview, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.