Individual
MI MI KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
105 MEDICAL CENTER DR, SLIDELL, LA 70461-5544
(985) 898-7054
(985) 661-3549
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
338711
LA
207LP2900X
Pain Medicine (Anesthesiology) Physician
338711
LA
207R00000X
Internal Medicine Physician
338711
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
01/02/2024
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