Individual
KIUP ALEXANDER KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, RPVI
Contact information
Practice address
202 E EARLL DR STE 360, PHOENIX, AZ 85012-2677
(480) 788-5621
(480) 779-1277
Mailing address
202 E EARLL DR STE 360, PHOENIX, AZ 85012-2677
(480) 788-5621
(480) 779-1277
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
42708
AZ
2086S0129X
Vascular Surgery Physician
Primary
42708
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225242985
NPI
AZ
05
—
501341
—
AZ
01
—
Z139140
PTAN
AZ
Enumeration date
05/10/2007
Last updated
08/05/2021
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