Doctor Name: | DR. KYONG SU MIN |
NPI Number: | 1972737153 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 25831 |
Business Practice Address: | 9040 Fitzsimmons Dr Orthopaedic Surgery Tacoma, WA - 984311000 |
Business Phone Number: | 2539680167 |
Business Fax Number: | 2539685327 |
Mailing Address: | 9040 Fitzsimmons Dr, Orthopaedic Surgery TACOMA |
State: | WA |
Postal Code: | 984311000 |
Phone Number: | 2539680167 |
Fax Number: | 2539685327 |
NPI Enumeration Date: | 05/04/2009 |
NPI Last Update Date: | 09/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25831 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |