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General NPI Number Information
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NPI Number | 1952592545
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Entity Type | Individual
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Provider Name | JEEHUN MICHAEL KIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL UNIT 15245
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City | APO
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State | AP
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Zip | 96271
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Country | US
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Telephone | 315-737-1219
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Fax |
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Provider Business Mailing Address
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Address Line | BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL UNIT 15245
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City | APO
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State | AP
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Zip | 96271
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD-14797
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2018-01435
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License Number State | NC
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