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Individual

CHARLES S. KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
631 CLEVELAND AVE S STE 5, SAINT PAUL, MN 55116-1244
(984) 377-3422
Mailing address
PO BOX 11839, SAINT PAUL, MN 55111-0839
(984) 377-3422
(855) 740-1940

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
41236
TN
208100000X
Physical Medicine & Rehabilitation Physician
41236
TN
208100000X
Physical Medicine & Rehabilitation Physician
Primary
57253
MN

Other

Enumeration date
06/07/2006
Last updated
03/17/2018
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