Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | SK010029 | MI |
NPI | 1427037282 |
---|---|
Provider Name | Dr. Steven Joe Kin |
First Address | West Bloomfield, MI 48323-2191 |
Second Address | West Bloomfield, MI 48323-2191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 06/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38-3440894 | FEDERAL TAX ID FOR CORP. (01) | MI |
4100363 | (05) | MI |
4100372 | (05) | MI |
F31235 | (02) | MI |