Provider Demographics
NPI:1497508253
Name:KIM, HUI UN (MD)
Entity Type:Individual
Prefix:MR
First Name:HUI UN
Middle Name:
Last Name:KIM
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 1:1350 EAST MARKET STREET
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483
Mailing Address - Country:US
Mailing Address - Phone:330-675-5706
Mailing Address - Fax:330-675-5720
Practice Address - Street 1:1350 EAST MARKET STREET, 7TH FLOOR
Practice Address - Street 2:7TH FLOOR
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483
Practice Address - Country:US
Practice Address - Phone:330-841-9470
Practice Address - Fax:330-841-9645
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program