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1306846167

NPI Code Detail

MEDICARE: DR. YOUNG C KIM MD

MEDICARE: DR. YOUNG C KIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	35045848	OH
2	2085R0202X	Diagnostic Radiology Physician	35.045848	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00600868	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000341983	OTHER	OH	BC/BS INDIVIDUAL PIN NO
2	000000559893	OTHER	OH	ANTHEM
3	000000234730	OTHER	OH	UNISON
4	0304914	OTHER	OH	BCMH
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306846167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOUNG C KIM MD

Provider Business Mailing Address
First Line	:	5655 HUDSON DRIVE
Second Line	:	SUITE 210
City	:	HUDSON
State	:	OH
Zip	:	44236-4451
Country	:	US
Telephone Number	:	330-655-3800
Fax Number	:	330-655-3828

Provider Business Practice Location Address
First Line	:	18697 BAGLEY ROAD
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3417
Country	:	US
Telephone Number	:	440-816-8770
Fax Number	:	440-816-8806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	09/03/2009

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Directions to “ DR. YOUNG C KIM MD” Practice Location

Language	Start Address	Practice Location

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