Kim, Seung Soo
Kim, Seung Soo is an individual health care provider with primary practice located at 11109 Parkview Plaza Dr , Fort Wayne IN 46845-1701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Kim, Seung Soo can be contacted via phone (260) 266-1000.Contact Information
Primary practice address
11109 Parkview Plaza Dr
Fort Wayne IN 46845-1701
Phone: (260) 266-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 01040258A | Indiana |
Profile Details
| NPI number | 1639153182 |
|---|---|
| LBN Legal business name | Kim, Seung Soo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 29th, 2005 |
| Last updated | Aug 21st, 2018 - about 6 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 | 1639153182 | NPPES |
| Indiana | MEDICAID | 100364240 |
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