Provider Demographics
NPI:1841315231
Name:KIM, SOON KUYN (MD)
Entity type:Individual
Prefix:DR
First Name:SOON
Middle Name:KUYN
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:29433 SOUTHFIELD RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2031
Mailing Address - Country:US
Mailing Address - Phone:248-905-5091
Mailing Address - Fax:
Practice Address - Street 1:29433 SOUTHFIELD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2031
Practice Address - Country:US
Practice Address - Phone:248-905-5091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010318322084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry