Individual
GEORGE S KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(574) 294-2621
(574) 273-1137
Mailing address
4755 AMERITECH DR, SUITE A, SOUTH BEND, IN 46628-9120
(574) 271-2558
(574) 273-1137
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0159032
IN
207P00000X
Emergency Medicine Physician
4301510325
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000336004
ANTHEM
IN
05
—
104637656
—
MI
05
—
200244530
—
IN
01
—
P00203877
RAIL ROAD MEDICARE
IN
Enumeration date
07/21/2005
Last updated
05/14/2025
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