Kim, Michael M

Kim, Michael M is an individual health care provider with primary practice located at 2525 Nw Lovejoy St Ste 402 , Portland OR 97210-2865. He recently has only one registered license in Allopathic & Osteopathic Physicians / Facial Plastic Surgery, which is considered as his primary health care specialty. Kim, Michael M can be contacted via phone (503) 575-1910.

Contact Information

Primary practice address
2525 Nw Lovejoy St Ste 402 Portland OR 97210-2865
Phone: (503) 575-1910
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X MD27979 Oregon
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X 42031 Arizona

Profile Details

NPI number 1689720468
LBN Legal business name Kim, Michael M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2007
Last updated Feb 2nd, 2020 - about 6 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 1689720468 NPPES
Arizona MEDICAID 433505
Arizona MEDICAID 218503
Arizona MEDICAID 807968400

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