Individual
JAE YONG KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1922 MONROE ST, DEARBORN, MI 48124-2917
(313) 274-7540
Mailing address
1922 MONROE ST, DEARBORN, MI 48124-2917
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301507485
MI
207W00000X
Ophthalmology Physician
A171816
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2017
Last updated
02/12/2024
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