Provider Demographics
NPI:1104087923
Name:KIM, MI HYE (DC)
Entity type:Individual
Prefix:
First Name:MI
Middle Name:HYE
Last Name:KIM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 LIMESTONE RD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5536
Mailing Address - Country:US
Mailing Address - Phone:267-320-8971
Mailing Address - Fax:
Practice Address - Street 1:2055 LIMESTONE RD
Practice Address - Street 2:SUITE 213
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5536
Practice Address - Country:US
Practice Address - Phone:267-320-8971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000871111N00000X
PADC010052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor