MEDICARE: DR. STEVEN EUNSIK KIM M.D.

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	207RN0300X	Nephrology Physician	MA58125	NJ

General Provider Information

NPI Number	:	1457435646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN EUNSIK KIM M.D.

Provider Business Mailing Address
First Line	:	D5 BRIER HILL CT
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-3335
Country	:	US
Telephone Number	:	732-432-7400
Fax Number	:	732-432-7401

Provider Business Practice Location Address
First Line	:	D5 BRIER HILL CT
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-3335
Country	:	US
Telephone Number	:	732-432-7400
Fax Number	:	732-432-7401

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	09/21/2007

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