Provider Demographics
NPI:1093776544
Name:KIM, SEUNG HWAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SEUNG
Middle Name:HWAN
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5215 HACIENDA DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-5425
Mailing Address - Country:US
Mailing Address - Phone:210-656-3608
Mailing Address - Fax:210-916-5495
Practice Address - Street 1:3851 ROGER BROOKE,DRIVE
Practice Address - Street 2:MCHE-QD(CREDS),
Practice Address - City:FORT SAM HOUSTON,
Practice Address - State:TX
Practice Address - Zip Code:78234-6200
Practice Address - Country:US
Practice Address - Phone:210-916-5703
Practice Address - Fax:210-916-5495
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF-5979207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology