Individual
JAE HOON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3535 W 13 MILE RD STE 247, ROYAL OAK, MI 48073-6770
(248) 551-4149
(248) 551-4150
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(248) 551-4149
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LP04718
RI
207RN0300X
Nephrology Physician
Primary
5101027937
MI
207RN0300X
Nephrology Physician
OL61280717
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
10/30/2024
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