Kwonsoo Kenneth Kim, MD is a
Anesthesiology physician based in South Lyon, Michigan. Kwonsoo Kenneth Kim is licensed to practice in Michigan (license number 4301034988) and his current practice location is 8854 Stoney Creek Dr., South Lyon, Michigan. He can be reached at his office (for appointments etc.) via phone at
(248) 486-0586.
NPI number for Kwonsoo Kenneth Kim is 1043633191 and his current mailing address is 8854 Stoney Creek Dr., South Lyon, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1043633191.
Physician's Profile
Full Name | Kwonsoo Kenneth Kim |
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Gender | Male |
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Speciality | Anesthesiology |
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Location | 8854 Stoney Creek Dr., South Lyon, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1043633191
- Provider Enumeration Date: 01/27/2014
- Last Update Date: 01/27/2014
Medical Identifiers
Medical identifiers for Kwonsoo Kenneth Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1043633191 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207L00000X | Anesthesiology | 4301034988 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kwonsoo Kenneth Kim is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kwonsoo Kenneth Kim, MD 8854 Stoney Creek Dr., South Lyon, MI 48178 Ph: (248) 486-0586 | Kwonsoo Kenneth Kim, MD 8854 Stoney Creek Dr., South Lyon, MI 48178 Ph: (248) 486-0586 |
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