Doctor Name: | DR. MICHAEL D KIM |
NPI Number: | 1427002179 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | OS012236 |
Business Practice Address: | 802 Jefferson Ave 5th Floor Scranton, PA - 185101038 |
Business Phone Number: | 5703481118 |
Business Fax Number: | 5703481109 |
Mailing Address: | 802 Jefferson Ave, 5th Floor SCRANTON |
State: | PA |
Postal Code: | 185101038 |
Phone Number: | 5703481118 |
Fax Number: | 5703481109 |
NPI Enumeration Date: | 05/19/2006 |
NPI Last Update Date: | 04/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | OS012236 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |