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NPI Code Detail

MEDICARE: DR. INKYUNG KIM SANTIAGO M.D

MEDICARE:  DR. INKYUNG KIM SANTIAGO  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
1207R00000XInternal Medicine Physician30043AL

General Provider Information

NPI Number : 1780856781
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. INKYUNG KIM SANTIAGO M.D
Provider Business Mailing Address
First Line : 261 WEDGEWOOD TERRACE RD
Second Line :
City : MADISON
State : AL
Zip : 35757-8911
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1350 14TH AVE SE
Second Line :
City : DECATUR
State : AL
Zip : 35601-4364
Country : US
Telephone Number : 256-355-6911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2008
Last Update Date : 10/21/2022

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Directions to “ DR. INKYUNG KIM SANTIAGO M.D” Practice Location

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