Individual
CHAN WOO KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4741
(401) 444-4445
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4741
(401) 444-4445
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
LP05521
RI
Other
Enumeration date
06/12/2022
Last updated
06/12/2022
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