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General NPI Number Information
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NPI Number | 1366638819
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Entity Type | Organization
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Legal Business Name | SEONG CHEOL KIM, MD, PA
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 1012 N GALLOWAY AVE STE 102
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City | MESQUITE
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State | TX
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Zip | 75149-2461
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Country | US
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Telephone | 214-660-2533
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Fax | 214-660-2525
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Provider Business Mailing Address
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Address Line | PO BOX 851978
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City | MESQUITE
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State | TX
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Zip | 75185-1978
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Country | US
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Telephone | 214-660-2533
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Fax | 214-660-2525
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Authorized Official
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Title or Position | MD
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Name | DR. SEONG CHEOL KIM
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Credential | MD
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Telephone | 214-660-2533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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