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General NPI Number Information
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NPI Number | 1366088528
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Entity Type | Individual
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Provider Name | SONYA KIM
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Gender | Female
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Dates
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Enumeration Date | 11/22/2019
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 1771 E MICHIGAN AVE
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City | YPSILANTI
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State | MI
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Zip | 48198-6069
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Country | US
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Telephone | 734-482-9342
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Fax | 734-483-8649
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Provider Business Mailing Address
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Address Line | 2145 HACKAMORE DR
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City | ANN ARBOR
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State | MI
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Zip | 48103-1405
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Country | US
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Telephone | 734-272-3787
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Fax | 734-483-8649
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 5315113200
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License Number State | MI
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