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Individual
MIN PETER KIM
Active
Individual
MIN PETER KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
N0168
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558689661
BLUE CROSS BLUE SHIELD
TX
05
—
216129101
—
TX
05
—
216129102
—
TX
01
—
8CJ565
BCBS
TX
01
—
P00936712
MEDICARE RR
TX
01
—
P01120347
RR MEDICARE
TX
Enumeration date
05/13/2010
Last updated
01/17/2017
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