MEDICARE: STEVEN C. KIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	01065756A	IN

General Provider Information

NPI Number	:	1750331195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN C. KIM MD

Provider Business Mailing Address
First Line	:	30 W RAMPART ST
Second Line	:	SUITE 200
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-8846
Country	:	US
Telephone Number	:	317-421-2012
Fax Number	:	317-398-1851

Provider Business Practice Location Address
First Line	:	2451 INTELLIPLEX DR STE 295
Second Line	:
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-8580
Country	:	US
Telephone Number	:	317-398-5237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	10/12/2021

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