Individual
CHUNG K KIM
Active
Individual
CHUNG K KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01030918A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084854
BLUE CROSS PROVIDER NUMBE
IN
Enumeration date
06/16/2006
Last updated
01/03/2011
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