Provider Demographics
NPI:1063529212
Name:KIM, DAVID K (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:K
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:70 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1397
Mailing Address - Country:US
Mailing Address - Phone:614-839-2128
Mailing Address - Fax:614-790-1023
Practice Address - Street 1:6785 BOBCAT WAY STE 300
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-1443
Practice Address - Country:US
Practice Address - Phone:614-890-6555
Practice Address - Fax:614-823-8881
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.076545207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2120565Medicaid
OHKI0882534Medicare PIN
OH2120565Medicaid