Provider Demographics
NPI:1568451649
Name:KIM, WALTER HYUN (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:HYUN
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:11000 N SCOTTSDALE RD STE 115
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6168
Mailing Address - Country:US
Mailing Address - Phone:480-372-9497
Mailing Address - Fax:805-980-5535
Practice Address - Street 1:11000 N SCOTTSDALE RD STE 115
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6168
Practice Address - Country:US
Practice Address - Phone:480-372-9497
Practice Address - Fax:805-980-5535
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ64496207RX0202X, 208D00000X
CAA86185207UN0902X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy