Kim, Kyung Soo

Kim, Kyung Soo is an individual health care provider with primary practice located at 14049 E 13 Mile Rd Ste 1 , Warren MI 48088-5876. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Nuclear Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Kim, Kyung Soo can be contacted via phone (586) 415-0103.

Contact Information

Primary practice address
14049 E 13 Mile Rd Ste 1 Warren MI 48088-5876
Phone: (586) 415-0103
Fax: (586) 415-0108
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 4301032265 Michigan
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X 4301032265 Michigan

Profile Details

NPI number 1558363119
LBN Legal business name Kim, Kyung Soo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Mar 7th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558363119 NPPES
Michigan Other 060-507-4551 BLUECROSSBLUESHIELD
Michigan Other OH-26467002 BLUECROSSBLUESHIELD

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