KYUNG SOO KIM (NPI# 1558363119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558363119 |
| Entity Type | Individual |
| Full Name | KYUNG SOO KIM |
| Credential | MD |
| Practice Address |
14049 E 13 Mile Rd Ste 1 Warren MI 48088-5876 |
| Mailing Address |
49050 Schoenherr Rd Ste 100 Shelby Twp MI 48315-3848 |
| Practice Telephone | 5864150103 |
| Practice Fax Number | 5864150108 |
| Mailing Telephone | 5865667870 |
| Mailing Fax Number | 5865667850 |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2018-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4301032265 | MI | Allopathic & Osteopathic Physicians |
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
4301032265 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE ID | OH-26467002 | 01 |
| MI | BLUECROSSBLUESHIELD | 060-507-4551 | 01 |
| MI | DEA | AK5563982 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922590058 | Kyung Soo Kim | Acupuncturist | 170 Evergreen Rd Apt 5a, Edison, NJ 08837-2444 | 2018-06-04 |
| 1265976898 | Kyung M Kim | Occupational Therapist | 14390 Uniform Dr, Centreville, VA 20121-2321 | 2016-12-16 |
| 1013364421 | Kyung Sook Kim | Anesthesiology | 5 Floral Park Ct, Savoy, IL 61874-9761 | 2016-05-16 |
| 1750761995 | Kyung Kim | Pediatrics | 251 Columbia Club Dr E, Blythewood, SC 29016-9479 | 2015-06-03 |
| 1902139934 | Kyung Sik Kim | Acupuncturist | 3150 Southwycke Ter, Fremont, CA 94536-1960 | 2009-09-09 |
| 1497980437 | Kyung Taek Kim | Acupuncturist | 1481 S King Street, #106, Honolulu, HI 96814 | 2009-05-20 |
| 1134344419 | Kyung Hee Kim | Social Worker | 12356 Donovan Cir, Austin, TX 78753-7220 | 2007-04-13 |
| 1831210335 | Kyung Han Kim | Physical Therapist | 4304 Evergreen Ln Ste 102, Annandale, VA 22003-3216 | 2007-04-02 |
| 1790816627 | Kyung Ja Kim | Acupuncturist | 4482 Barranca Pkwy Ste 248, Irvine, CA 92604-4770 | 2007-03-09 |
| 1922140425 | Kyung Il Kim | Dentist | 214 20 45 Road, Bayside, NY 11361-3338 | 2007-02-12 |
| Street Address |
14049 E 13 MILE RD STE 1 |
| City | WARREN |
| State | MI |
| Zip Code | 48088-5876 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821171232 | Vision Institute of Michigan PC | Technician/Technologist | 14049 E 13 Mile Rd Ste 1, Warren, MI 48088-5876 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457980609 | Berkley Pharmacy LLC | Pharmacy | 28577 Schoenherr Road, Warren, MI 48088 | 2020-04-08 |
| 1023679099 | Jeff Lip | Counselor | 13253 Cromie Dr., Warren, MI 48088 | 2019-06-21 |
| 1306229877 | Medico Care LLC | Health Maintenance Organization | 31418 Schoenherr Rd #5, Warren, MI 48088 | 2015-07-02 |
| 1053728030 | Jane Kennedy Bays | Counselor | 30521 Schoenherr Rd Ste 200, Warren, MI 48088 | 2014-07-22 |
| 1114295490 | Ma Corazon E Marcaida-gorospe | Physical Therapist | 27472 Schoenherr Road, Warren, MI 48088 | 2011-12-01 |
| 1578869277 | Chiropractic Urgent Care, P.C. | Clinic/Center | 31500 Schoenherr Rd., Warren, MI 48088 | 2011-01-28 |
| 1396071361 | Colleen Janness | Physician Assistant | 13450 East 12 Mile Rd, Advanced Dermatology of Michigan, PC, Warren, MI 48088 | 2009-10-27 |
| 1225266075 | Pain Management Center | General Practice | 27472 Schoneherr, #130, Warren, MI 48088 | 2009-06-30 |
| 1447495809 | Denise Stys Marecki | Dietitian, Registered | 30061 Schoenherr Rd., Suite C, Warren, MI 48088 | 2008-12-12 |
| 1568640878 | James H. Aronovitz, Do Pllc | Otolaryngology | 27301 Schoenherr, 105, Warren, MI 48088 | 2008-02-08 |
| Find all providers in zip 48088 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184893471 | Vijay B Behari Md Inc | Internal Medicine | 1700 East Market St, Suite 101, Warren, OH 44483-6625 | 2008-02-21 |
| 1417936238 | Larry A Woods | Internal Medicine | 9375 E Market St Ste 3, Warren, OH 44484-5552 | 2006-01-11 |
| 1487636684 | Inderjit Aggarwal | Internal Medicine | 29610 Ryan Rd, Warren, MI 48092-4247 | 2005-11-15 |
| 1528058773 | Theodore L Schreiber | Internal Medicine | 8545 Common Road, Ste 150, Warren, MI 48093 | 2005-10-27 |
| 1144219684 | Robert K Moore | Internal Medicine | 28341 Hoover Rd, Warren, MI 48093-4151 | 2005-10-18 |
| 1326032590 | Cardiac Management Inc | Internal Medicine | 1753 E Market St, Suite 1, Warren, OH 44483-6672 | 2005-09-02 |
| 1093296592 | Pioneer Medical Associates P.C. | Internal Medicine | 27560 Hoover Rd, Warren, MI 48093 | 2018-08-23 |
| 1194031682 | Robert K Moore Md PC | Internal Medicine | 28341 Hoover Rd, Warren, MI 48093-4151 | 2010-08-23 |
| 1376797217 | Oakland Medical Group PC | Internal Medicine | 11900 E 12 Mile Rd, Suite 300, Warren, MI 48093-3400 | 2008-11-05 |
| 1720251010 | Cardiac Electrophysiology, Pa | Internal Medicine | 161 Washington Valley Road, Suite 201, Warren, NJ 07059-7177 | 2008-04-08 |
| Find all providers in WARREN | ||||
Please comment or provide details below to improve the information on KYUNG SOO KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.