Kim, Jong H
Kim, Jong H is an individual health care provider with primary practice located at 200 E 80Th Pl Ste 100E, Merrillville IN 46410-5671. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kim, Jong H can be contacted via phone (219) 769-7536.Contact Information
Primary practice address
200 E 80Th Pl Ste 100E
Merrillville IN 46410-5671
Phone: (219) 769-7536
Fax: (219) 736-1506
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01036861A | Indiana |
Profile Details
| NPI number | 1891797569 |
|---|---|
| LBN Legal business name | Kim, Jong H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 12th, 2005 |
| Last updated | Jun 3rd, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891797569 | NPPES |
| Other | 0000066817103 | UNITED HEALTHCARE | |
| Other | 000000080494 | UNITED HEALTHCARE | |
| Other | AS65769900001 | UNITED HEALTHCARE | |
| Other | 4520196 | UNITED HEALTHCARE | |
| Other | 00000053287J | UNITED HEALTHCARE | |
| Other | 452016 | UNITED HEALTHCARE | |
| MEDICAID | 100200870 | UNITED HEALTHCARE |
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