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General NPI Number Information
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NPI Number | 1750618633
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Entity Type | Organization
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Legal Business Name | HIJOO KIM MD PLLC
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 22001 KELLY RD
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-777-1120
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Fax | 586-777-9690
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Provider Business Mailing Address
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Address Line | 22001 KELLY RD
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-777-1120
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Fax | 586-777-9690
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Authorized Official
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Title or Position | OWNER
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Name | HIJOO KIM
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Credential | MD
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Telephone | 248-646-3343
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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 | 4301035503
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License Number State | MI
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