Provider Demographics
NPI:1568451649
Name:KIM, WALTER HYUN (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:HYUN
Last Name:KIM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16220 N SCOTTSDALE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1798
Mailing Address - Country:US
Mailing Address - Phone:866-792-1191
Mailing Address - Fax:949-703-8203
Practice Address - Street 1:16220 N SCOTTSDALE RD STE 300
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-1798
Practice Address - Country:US
Practice Address - Phone:866-792-1191
Practice Address - Fax:949-703-8203
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86185207UN0902X, 208D00000X
AZ64496208D00000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice