Provider Demographics
NPI:1427002179
Name:KIM, MICHAEL D (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:KIM
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:5 MORGAN HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-2641
Mailing Address - Country:US
Mailing Address - Phone:570-344-3788
Mailing Address - Fax:570-969-9280
Practice Address - Street 1:475 MORGAN HWY
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2605
Practice Address - Country:US
Practice Address - Phone:570-348-1118
Practice Address - Fax:570-348-1109
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2024-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS0122362084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine