JAE HO KIM (NPI# 1902966310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902966310 |
| Entity Type | Individual |
| Full Name | JAE HO KIM |
| Credential | M.D. |
| Practice Address |
2799 W Grand Blvd Detroit MI 48202-2608 |
| Practice Telephone | 3139162600 |
| Practice Fax Number | 3139163235 |
| Mailing Telephone | 3139162600 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
4301055250 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
2799 W GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48202-2608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235132069 | Donna Prince | Radiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2005-05-24 |
| 1790386704 | Alexandria L Blevins | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-11-05 |
| 1255932430 | Amy Katlyn Carion | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-11-04 | |
| 1871194415 | Alexandria Denise Roberts | Physical Therapist | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2020-11-02 |
| 1174121420 | John Charles Sanno | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2020-10-09 |
| 1932706991 | Fallon J Awe | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-02 |
| 1922615145 | Chelsea Elizabeth Owen | Nurse Anesthetist, Certified Registered | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-01 |
| 1275130395 | Zana Latkovac | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-01 |
| 1487260030 | Jessica Lee Moret | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-09-18 |
| 1932713237 | Lucas Costa Santos | Anesthesiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184664450 | Nejat Akbiyik | Radiology | 4100 John R., Detroit, MI 48201 | 2006-06-07 |
| 1487693750 | University Radiation Oncologists | Radiology | 4100 John R. St., Detroit, MI 48201 | 2006-06-05 |
| 1851958250 | Daniel Joseph Chapman | Radiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2019-05-22 |
| 1861923369 | Andrew Cook | Radiology | 2799 W Grand Blvd, Detroit, MI 48202 | 2017-03-25 |
| 1043681174 | Vhs Sinai-grace Hospital Inc | Radiology | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2015-10-15 |
| 1013302397 | David Michael Bergman | Radiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2015-04-02 |
| 1164762464 | Keqin Tang | Radiology | 4646 John R St, Dept of Radiation Oncology, R# Ll 40, Detroit, MI 48201-1916 | 2013-02-22 |
| 1396010922 | M. Salim Un-nabi Siddiqui | Radiology | 2799 W Grand Blvd Dept Of, Henry Ford Hospital, Detroit, MI 48202-2608 | 2012-03-15 |
| 1578846440 | Zishan Alibhai | Radiology | 540 E Canfield St, 1212 Scott Hall, Detroit, MI 48201-1928 | 2011-09-27 |
| 1972884286 | Abhirami Hallock | Radiology | 4201 Saint Antoine St, 1d Uhc, Detroit, MI 48201-2153 | 2011-08-31 |
| Find all providers in DETROIT | ||||
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| 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.