Individual
JAE HONG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3333 BURNET AVENUE, MLC 7009, CINCINNATI, OH 45229-3026
(513) 636-4830
(513) 636-7868
Mailing address
3333 BURNET AVENUE, MLC 7009, CINCINNATI, OH 45229-3026
(513) 636-4830
(513) 636-7868
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C52431
CA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
35.136969
OH
2080N0001X
Neonatal-Perinatal Medicine Physician
C52431
CA
2080P0206X
Pediatric Gastroenterology Physician
C52431
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C524310
—
CA
Enumeration date
11/16/2006
Last updated
06/01/2021
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