Individual
KU JUNG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3131 QUEEN CITY AVE, CINCINNATI, OH 45238-2316
(859) 341-7246
(859) 341-7867
Mailing address
20 MEDICAL VILLAGE DR, STE 258, EDGEWOOD, KY 41017-5401
(859) 341-7246
(859) 341-7867
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35047896K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000230803
ANTHEM BLUE SHIELD
—
05
—
0555304
—
OH
05
—
200320210
—
IN
01
—
404138398
HEALTHNET
—
01
—
48359301
DEPT OF LABOR
—
05
—
64048911
—
KY
Enumeration date
11/18/2005
Last updated
02/20/2008
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