Individual
DR. MICHAEL M KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 NW LOVEJOY ST STE 402, PORTLAND, OR 97210-2865
(503) 575-1910
Mailing address
2525 NW LOVEJOY ST STE 402, PORTLAND, OR 97210-2865
(503) 575-1910
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
42031
AZ
207YS0123X
Facial Plastic Surgery Physician
Primary
MD27979
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218503
—
OR
05
—
433505
—
AZ
05
—
807968400
—
ID
Enumeration date
01/26/2007
Last updated
02/02/2020
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