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General NPI Number Information
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NPI Number | 1134459969
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Entity Type | Organization
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Legal Business Name | WOOK KIM MD PC
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Dates
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Enumeration Date | 12/29/2009
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 29877 TELEGRAPH RD SUITE 401
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City | SOUTHFIELD
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State | MI
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Zip | 48034-7661
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Country | US
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Telephone | 248-651-8344
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Fax | 248-651-8024
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Provider Business Mailing Address
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Address Line | 29877 TELEGRAPH RD SUITE 401
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City | SOUTHFIELD
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State | MI
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Zip | 48034-7661
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Country | US
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Telephone | 248-651-8344
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Fax | 248-651-8024
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SIMRAT DHILLON
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Credential |
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Telephone | 248-651-8344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 4301099580
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 5315052216
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036156
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License Number State | MI
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