Individual
KWONSOO KENNETH KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8854 STONEY CREEK DR., SOUTH LYON, MI 48178
(248) 486-0586
Mailing address
8854 STONEY CREEK DR., SOUTH LYON, MI 48178
(248) 486-0586
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301034988
MI
Other
Enumeration date
01/27/2014
Last updated
01/27/2014
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