Individual
RICHARD KYUNGHO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1210 MEDICAL ARTS BLVD STE 217B, ANDERSON, IN 46011-3461
(765) 298-4470
(765) 298-4975
Mailing address
499 E HAMPDEN AVE #220, ENGLEWOOD, CO 80113-2792
(303) 783-8844
(303) 783-2002
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01074190A
IN
207T00000X
Neurological Surgery Physician
55280
CO
207T00000X
Neurological Surgery Physician
MT190323
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300054280
—
IN
01
—
MT190323
STATE OF PA
PA
Enumeration date
03/25/2009
Last updated
09/23/2021
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