Doctor Name: | WANG KI KIM |
NPI Number: | 1649345349 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 1233901 |
Business Practice Address: | 100 Memorial Drive Gowanda, NY - 14070 |
Business Phone Number: | 7165329202 |
Business Fax Number: | |
Mailing Address: | 54425 Lakeshore Road, HAMBURG |
State: | NY |
Postal Code: | 14075 |
Phone Number: | 7166273776 |
Fax Number: | 7166271162 |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 05/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 1233901 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
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 |