Individual
CHUNG KIM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36475 FIVE MILE RD, LIVONIA, MI 48154-1971
(734) 655-4800
Mailing address
14555 LEVAN #310, LIVONIA, MI 48154-5085
(734) 591-1171
(734) 591-1656
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301039736
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3516119
—
MI
Enumeration date
04/20/2006
Last updated
07/08/2007
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