Kim, Chang Soo

Kim, Chang Soo is an individual health care provider with primary practice located at 16420 East 9 Mile Rd , Eastpointe MI 48021-2442. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kim, Chang Soo can be contacted via phone (586) 779-0000.

Contact Information

Primary practice address
16420 East 9 Mile Rd Eastpointe MI 48021-2442
Phone: (586) 779-0000
Fax: (586) 779-9866
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X CK031478 Michigan

Profile Details

NPI number 1699797449
LBN Legal business name Kim, Chang Soo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699797449 NPPES
Michigan MEDICAID 1093837

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