Individual
CHARLES J KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 CASS AVE, WOONSOCKET, RI 02895-4705
(401) 769-4100
(401) 767-1606
Mailing address
1 ABBOTT VALLEY VIEW DR, CUMBERLAND, RI 02864-4103
(401) 333-6608
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD04437
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CK00204
—
RI
Enumeration date
11/01/2006
Last updated
07/08/2007
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