MEDICARE: HYUN-SU KIM DO

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1972445328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYUN-SU KIM DO

Provider Business Mailing Address
First Line	:	3915 WILLIAM E MURRAY BLVD UNIT 1231
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5231
Country	:	US
Telephone Number	:	408-613-8561
Fax Number	:

Provider Business Practice Location Address
First Line	:	4190 CITY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1626
Country	:	US
Telephone Number	:	215-871-6645
Fax Number	:

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

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “ HYUN-SU KIM DO” Practice Location

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