Individual
YONJAE JOSHUA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8865 W 400 N STE 175, MICHIGAN CITY, IN 46360-9010
(219) 877-2225
(219) 877-2230
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01100298A
IN
208600000X
Surgery Physician
036.169189
IL
2086S0129X
Vascular Surgery Physician
Primary
01100298A
IN
Other
Enumeration date
03/27/2017
Last updated
07/14/2026
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