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General NPI Number Information
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NPI Number | 1972541332
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Entity Type | Organization
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Legal Business Name | KIM YU MD PC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 8555 N SILVERY LN SUITE 402
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-1379
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Country | US
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Telephone | 313-561-0550
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Fax | 313-561-3646
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Provider Business Mailing Address
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Address Line | 8555 N SILVERY LN SUITE 402
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-1379
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Country | US
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Telephone | 313-561-0550
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Fax | 313-561-3646
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. KIM YU
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Credential | MD
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Telephone | 313-651-0550
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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 | 4301070014
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License Number State | MI
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