Individual
DR. CHARLES CHUNGSON KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 EDEN AVE, CINCINNATI, OH 45219-4231
(513) 475-8523
(513) 475-7327
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 245-3104
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35085872
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35 085872
OH
207RP1001X
Pulmonary Disease Physician
Primary
35 085872
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200913790
—
IN
05
—
2829014
—
OH
05
—
7100034460
—
KY
Enumeration date
07/12/2006
Last updated
08/21/2017
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