Provider Demographics
NPI:1548245061
Name:KIM, STEUNG IL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEUNG
Middle Name:IL
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 1:18TH MEDCOM
Mailing Address - Street 2:ATTN: DCCS-QM CREDENTIALS
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-0054
Mailing Address - Country:KR
Mailing Address - Phone:0118227-916-6027
Mailing Address - Fax:0118227-917-8110
Practice Address - Street 1:121 GENERAL HOSPITAL
Practice Address - Street 2:OB GYN DEPT
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205
Practice Address - Country:KR
Practice Address - Phone:0118227-917-6558
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125131207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology