Individual
EDWARD J KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-2152
Mailing address
PO BOX 9589, BOISE, ID 83707-4589
(208) 472-8109
(208) 344-1926
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
M9353
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807277300
—
ID
Enumeration date
06/07/2006
Last updated
05/15/2008
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