Kim, Miriam Grace
Kim, Miriam Grace is an sole proprietor health care provider with primary practice located at 705 Riley Hospital Dr Roc 4340, Indianapolis IN 46202-5109. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as her primary health care specialty. Kim, Miriam Grace can be contacted via phone (317) 944-2143.Contact Information
Primary practice address
705 Riley Hospital Dr Roc 4340
Indianapolis IN 46202-5109
Phone: (317) 944-2143
Fax: (317) 944-3107
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 02005955A | Indiana |
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 63854-21 | Wisconsin |
Profile Details
| NPI number | 1891052171 |
|---|---|
| LBN Legal business name | Kim, Miriam Grace |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 11th, 2012 |
| Last updated | Apr 8th, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891052171 | NPPES |
| Indiana | MEDICAID | 300036343 |
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