Provider Demographics
NPI:1124388459
Name:KIM, HYUNNARM (DO)
Entity Type:Individual
Prefix:MS
First Name:HYUNNARM
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MSC11 6093 1 UNIVERSITY OF NM
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-5156
Mailing Address - Country:US
Mailing Address - Phone:505-272-6225
Mailing Address - Fax:505-272-5184
Practice Address - Street 1:MSC11 6093 1 UNIVERSITY OF NM
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-5156
Practice Address - Country:US
Practice Address - Phone:505-272-6225
Practice Address - Fax:505-272-5184
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program