Individual
DR. KYUNGMI KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 691-8646
Mailing address
12745 S SAGINAW ST, 806-196, GRAND BLANC, MI 48439-2437
(248) 691-8646
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MA66347
NJ
208M00000X
Hospitalist Physician
Primary
4301108670
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0358979000
AMERIHEALTH
NJ
01
—
0M88530
MEDICARE
MI
05
—
7395108
—
NJ
Enumeration date
06/10/2006
Last updated
04/11/2017
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