Provider Demographics
NPI:1194031542
Name:NAM, KYUNG HUN (MD)
Entity Type:Individual
Prefix:DR
First Name:KYUNG
Middle Name:HUN
Last Name:NAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MUNGER PAVILION, ROOM 253
Mailing Address - Street 2:NEW YORK MEDICAL COLLEGE, DEPARTMENT OF MEDICINE
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:347-533-0912
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD - MS1045
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-1559
Practice Address - Fax:913-945-6403
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS9408197207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program