Individual
DR. PETER TAE WAN KIM
Active
Individual
DR. PETER TAE WAN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
N1367
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304424001
—
TX
Enumeration date
07/31/2008
Last updated
11/20/2012
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