Individual
MIRIAM GRACE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
705 RILEY HOSPITAL DR, ROC 4340, INDIANAPOLIS, IN 46202-5109
(317) 944-2143
(317) 944-3107
Mailing address
PO BOX 719094, CHICAGO, IL 60677-9318
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
02005955A
IN
2080P0207X
Pediatric Hematology & Oncology Physician
63854-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300036343
—
IN
Enumeration date
04/11/2012
Last updated
02/14/2026
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