CHANG SOO KIM (NPI# 1699797449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699797449 |
| Entity Type | Individual |
| Full Name | CHANG SOO KIM |
| Credential | MD |
| Practice Address |
16420 East 9 Mile Rd Eastpointe MI 48021-2442 |
| Practice Telephone | 5867790000 |
| Practice Fax Number | 5867799866 |
| Mailing Telephone | 5867790000 |
| Mailing Fax Number | 5867799866 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | CK031478 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1093837 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215149554 | Chang Soo Kim | Family Medicine | 3590 Peachtree Industrial Blvd, Duluth, GA 30096-4817 | 2007-05-07 |
| 1891719860 | Chang Soo Kim | Plastic Surgery | 999 Summer St, Stamford, CT 06905-5546 | 2006-07-26 |
| Street Address |
16420 EAST 9 MILE RD |
| City | EASTPOINTE |
| State | MI |
| Zip Code | 48021-2442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588137483 | Beautiful Tomorrow Inc | Home Health | 22430 Gratiot Ave., Eastpointe, MI 48021 | 2019-01-03 |
| 1760922553 | Urgent Care Plus, PC | Clinic/Center | 16184 E 10 Mile Rd Ste 102, Eastpointe, MI 48021 | 2017-02-28 |
| 1295187961 | Danielle Wansley | Licensed Practical Nurse | 24934 Rawen Ave, Eastpointe, MI 48021 | 2016-07-06 |
| 1548615966 | Unique Burton | Licensed Practical Nurse | 15025 Charles, Eastpointe, MI 48021 | 2016-05-04 |
| 1376908707 | Dalinda Richardson | Physical Therapist | 18200 E Tenmile Road, 200, Eastpointe, MI 48021 | 2015-12-30 |
| 1780050369 | Russell Marcilis II | Prosthetic/Orthotic Supplier | 18121 E. 8 Mile Ste 100, Eastpointe, MI 48021 | 2015-08-18 |
| 1841603594 | Charlotte Loraine Kroll | Dentist | 24541 Gratiot Ave., Eastpointe, MI 48021 | 2014-06-10 |
| 1114357720 | Zuri Tanay Boyd-mcgarrity | Social Worker | 4160 Woodward, 2nd Floor, Detroit, MI 48021 | 2013-11-18 |
| 1619219888 | Bettye Ruth Edwards | Social Worker | 23721 Kelly # 7, Eas Pointe, MI 48021 | 2013-03-26 |
| 1578807392 | Angela Marie Travis | Specialist | 21062 Kelly Road, Eastpoint, MI 48021 | 2012-11-16 |
| Find all providers in zip 48021 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457914913 | Serenity Wellness Center LLC | Internal Medicine | 17200 E 10 Mile Rd Ste 135, Eastpointe, MI 48021-3349 | 2019-04-19 |
| 1477978930 | Great Lakes Urgent Care PC of Eastside | Internal Medicine | 19070 E 10 Mile Rd, Eastpointe, MI 48021-1449 | 2014-02-20 |
| 1245536481 | Aneeta R Khanna Pllc | Internal Medicine | 20914 Kelly Rd, Eastpointe, MI 48021-3136 | 2011-02-06 |
| 1427289339 | Tesfamariam Okbay Metiku | Internal Medicine | 21409 Kelly Rd Ste 400, Eastpointe, MI 48021-3264 | 2009-07-28 |
| 1457400954 | Douglas Gregory Hames | Internal Medicine | 22850 Kelly Rd, Eastpointe, MI 48021-2028 | 2007-01-10 |
| 1326140179 | Gary G Bill | Internal Medicine | 21421 Kelly Road, Eastpointe, MI 48021 | 2006-09-02 |
| 1801904172 | Cigdem Levi | Internal Medicine | 21400 Kelly Road, Eastpointe, MI 48021 | 2006-08-28 |
| 1194731562 | Maryam Seyedi Md PC | Internal Medicine | 17000 E Ten Mile Road, Eastpointe, MI 48021 | 2006-07-31 |
| 1225051428 | Isis A Hanna | Internal Medicine | 22745 Kelly Rd, Eastpointe, MI 48021 | 2006-07-26 |
| 1467482521 | Konstantinos Kapordelis | Internal Medicine | 21421 Kelly Rd, Eastpointe, MI 48021-3215 | 2006-07-04 |
| Find all providers in EASTPOINTE | ||||
| City | EASTPOINTE |
| Zip Code | 48021 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.