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Individual

CHRISTINA J KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
13914 SOUTHEASTERN PKWY STE 203A, FISHERS, IN 46037-7125
(317) 582-9355
Mailing address
13914 SOUTHEASTERN PKWY STE 203A, FISHERS, IN 46037-7125

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01063630A
IN
2086X0206X
Surgical Oncology Physician
01063630A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000526962
ANTHEM
IN
01
000000609663
ANTHEM
IN
01
000000780867
ANTHEM
IN
05
200870490
IN
01
7264357
AETNA
IN
01
P01192259
RR MEDICARE PTAN
IN
Enumeration date
09/22/2006
Last updated
06/24/2024
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