MEDICARE: DR. GRACE E KIM M.D.

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	207RN0300X	Nephrology Physician	7330	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891745899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GRACE E KIM M.D.

Provider Business Mailing Address
First Line	:	7641 CHAROLAIS ST
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59106-9664
Country	:	US
Telephone Number	:	406-698-9742
Fax Number	:

Provider Business Practice Location Address
First Line	:	7641 CHAROLAIS ST
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59106-9664
Country	:	US
Telephone Number	:	406-698-9742
Fax Number	:

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	04/12/2017

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Directions to “ DR. GRACE E KIM M.D.” Practice Location

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