Kim, Jong D

Kim, Jong D is an individual health care provider with primary practice located at 4040 Coon Rapids Blvd Nw Suite 120, Coon Rapids MN 55433-4567. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Kim, Jong D can be contacted via phone (763) 427-9980.

Contact Information

Primary practice address
4040 Coon Rapids Blvd Nw Suite 120 Coon Rapids MN 55433-4567
Phone: (763) 427-9980
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 47957 Minnesota

Profile Details

NPI number 1679548036
LBN Legal business name Kim, Jong D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Nov 29th, 2011 - about 14 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 1679548036 NPPES
Minnesota MEDICAID 141600600

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