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General NPI Number Information
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NPI Number | 1609940113
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Entity Type | Individual
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Provider Name | DAVID DAEWHAN KIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 05/31/2018
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Provider Practice Location Address
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Address Line | HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
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City | DETROIT
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State | MI
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Zip | 48202
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Country | US
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Telephone | 313-916-2436
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Fax |
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Provider Business Mailing Address
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Address Line | HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
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City | DETROIT
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State | MI
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Zip | 48202
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Country | US
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Telephone | 313-916-2436
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Fax |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 4301066691
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 4301066691
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License Number State | MI
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