| Kyung Soo Kim, MD | |
|
14049 E 13 Mile Rd Ste 1, Warren, MI 48088-5876 | |
| (586) 415-0103 | |
| (586) 415-0108 |
| Full Name | Kyung Soo Kim |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Cardiovascular Disease |
| Location | 14049 E 13 Mile Rd Ste 1, Warren, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558363119 | NPI | - | NPPES |
| 060-507-4551 | Other | MI | BLUECROSSBLUESHIELD |
| OH-26467002 | Other | MI | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 4301032265 (Michigan) | Primary |
| 207UN0901X | Nuclear Medicine - Nuclear Cardiology | 4301032265 (Michigan) | Secondary |
| Entity Name | Advanced Cardiovascular Associates, Plc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790914687 PECOS PAC ID: 8921146291 Enrollment ID: O20091105000583 |
| Mailing Address | Practice Location Address |
|---|---|
| Kyung Soo Kim, MD 49050 Schoenherr Rd Ste 100, Shelby Twp, MI 48315-3848 Ph: (586) 566-7870 | Kyung Soo Kim, MD 14049 E 13 Mile Rd Ste 1, Warren, MI 48088-5876 Ph: (586) 415-0103 |
Rachel Marie Koch, D.O. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 11885 E 12 Mile Rd Ste 300a, Warren, MI 48093 Phone: 586-582-6630 Fax: 586-582-6631 | |
Jon Whitman Mackey, D.O. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 11885 E 12 Mile Rd Ste 300a, Warren, MI 48093 Phone: 586-582-6630 Fax: 586-582-6631 | |
Dr. Martin Irvin Schock, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 11885 E 12 Mile Rd, Suite 100a, Warren, MI 48093 Phone: 586-576-1615 Fax: 586-576-1628 | |
Salim Meram, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 11900 E 12 Mile Rd, Suite 100, Warren, MI 48093 Phone: 586-573-5890 Fax: 586-573-5525 | |
Larry B Tankanow, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 27472 Schoenherr Rd Ste 100, Warren, MI 48088 Phone: 586-751-8844 Fax: 586-751-8596 | |
Leslie Adele Scott, D.O. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 11885 E 12 Mile Rd Ste 300a, Warren, MI 48093 Phone: 586-582-6630 Fax: 586-582-6631 | |
Dr. Firas Zahwe, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 11900 E 12 Mile Rd Ste 308, Warren, MI 48093 Phone: 586-804-7525 Fax: 586-209-2486 |