Individual
THEODORE Y KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3851 PIPER ST STE U340, ANCHORAGE, AK 99508-6904
(907) 562-0321
(907) 562-0321
Mailing address
PO BOX 74900, CHICAGO, IL 60675-4900
(907) 562-0321
(907) 562-2683
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
129714
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1686607
—
AK
01
—
K169302
MEDICARE PTAN
AK
01
—
Q00801068
RAILROAD MEDICARE
AK
Enumeration date
07/27/2006
Last updated
01/22/2025
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