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General NPI Number Information
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NPI Number | 1205481041
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Entity Type | Organization
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Legal Business Name | SUNNY S. KIM, MD PA
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 1601 HIGHWAY 13 E STE 100
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City | BURNSVILLE
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State | MN
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Zip | 55337-6847
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Country | US
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Telephone | 320-763-8888
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Fax | 952-582-1607
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Provider Business Mailing Address
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Address Line | 1601 HIGHWAY 13 E STE 100
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City | BURNSVILLE
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State | MN
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Zip | 55337-6847
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Country | US
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Telephone | 320-763-8888
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Fax | 952-582-1607
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Authorized Official
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Title or Position | SVP/PRACTICE ADMINISTRATOR
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Name | MARYA C LYDEEN
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Credential |
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Telephone | 952-405-9760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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