Provider Demographics
NPI:1114688793
Name:DAVID HYUNGHWA KIM MD PLLC
Entity Type:Organization
Organization Name:DAVID HYUNGHWA KIM MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HYUNGHWA
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-691-6768
Mailing Address - Street 1:420 EAST 61ST STREET, #14E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8773
Mailing Address - Country:US
Mailing Address - Phone:717-691-6768
Mailing Address - Fax:
Practice Address - Street 1:420 EAST 61ST STREET, #14E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8773
Practice Address - Country:US
Practice Address - Phone:717-691-6768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty