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General NPI Number Information
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NPI Number | 1275152993
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Entity Type | Individual
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Provider Name | STEVEN DONG-WON KIM
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Gender | Male
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 33355 HEALTH CAMPUS BLVD
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City | AVON
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State | OH
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Zip | 44011-1399
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Country | US
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Telephone | 440-934-0489
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Fax |
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Provider Business Mailing Address
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Address Line | 1776 WOODSTEAD CT STE 208
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1480
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Country | US
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Telephone | 281-724-3050
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Fax | 512-628-3314
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 35.152122
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License Number State | OH
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