Doctor Name: | HEESUN NINA KIM |
NPI Number: | 1902965452 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | MD423883 |
Business Practice Address: | 705 Augusta Dr Bridgeville, PA - 150173437 |
Business Phone Number: | 9525951100 |
Business Fax Number: | 6122944903 |
Mailing Address: | 11995 Singletree Ln, Ste 500 EDEN PRAIRIE |
State: | MN |
Postal Code: | 553445347 |
Phone Number: | 9525951301 |
Fax Number: | 6122944903 |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 11/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | MD423883 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |