Healthcare Provider Details

I. General information

NPI: 1750331195
Provider Name (Legal Business Name): STEVEN C. KIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9240 N MERIDIAN ST STE 200
INDIANAPOLIS IN
46260-1827
US

IV. Provider business mailing address

30 W RAMPART ST SUITE 200
SHELBYVILLE IN
46176-8846
US

V. Phone/Fax

Practice location:
  • Phone: 317-689-0753
  • Fax: 317-343-2926
Mailing address:
  • Phone: 317-421-2012
  • Fax: 317-398-1851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number01065756A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: