Healthcare Provider Details

I. General information

NPI: 1831375575
Provider Name (Legal Business Name): HYO KIM MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37800 MOUND RD SUITE 1
STERLING HEIGHTS MI
48310-4128
US

IV. Provider business mailing address

37800 MOUND RD SUITE 1
STERLING HEIGHTS MI
48310-4128
US

V. Phone/Fax

Practice location:
  • Phone: 248-302-4151
  • Fax: 158-693-9722
Mailing address:
  • Phone: 248-302-4151
  • Fax: 158-693-9722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HYO KIM
Title or Position: PRESIDENT
Credential: MD
Phone: 248-302-4151