Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD-47291 | IA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 2016026447 | MO |
NPI | 1013303411 |
---|---|
Provider Name | Dr. Christopher Kim |
First Address | West Des Moines, IA 50266-9317 |
Second Address | West Des Moines, IA 50266-8233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2015 |
Last Update Date | 17/08/2021 |