Healthcare Provider Details

I. General information

NPI: 1467156562
Provider Name (Legal Business Name): EMILY VICTORIA KIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7798 DISCOVERY DR
WEST CHESTER OH
45069-7745
US

IV. Provider business mailing address

3200 BURNET AVE
CINCINNATI OH
45229-3019
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8264
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.156261
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: