Moon-Chul Kim, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301079022 Issued in MI

Practice address

1764 Stonebridge Dr S
Ann Arbor, MI 48108-8569

Phone

(734) 623-0238

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431734400000",
    "number": "1962583112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 STONEBRIDGE DR S",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481088569",
            "telephone_number": "734-623-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1764 STONEBRIDGE DR S",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481088569",
            "telephone_number": "734-623-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MOON-CHUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "MI",
            "license": "4301079022",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301079022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4347075",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Kim
• Karen Meekyong Kim, MD
• Kevin Keewoun Kim, MD
• Kwang Cho Kim, MD
• Michelle Miran Kim, M.D.
• Paul Kim, M.D.
• Scott Yung Ho Kim, MD, PHD
• Seohyeon Kim
• So Hyun Kim
• Sung Moon Kim, MD

• General Practice Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.