Individual
DAVID DAEWHAN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-2436
Mailing address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-2436
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
4301066691
MI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
4301066691
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250Q260840
BLUE CROSS-BLUE CROSS
—
05
—
447344610
—
MI
01
—
DK066691
CHAMPUS-CHAMPUS
—
Enumeration date
11/17/2006
Last updated
05/31/2018
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