Basic Information
| Provider Information | |||||||||
| NPI: | 1013974245 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIM | ||||||||
| FirstName: | CHEE | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6255 SHERIDAN DR | ||||||||
| Address2: | SUITE 304 | ||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142214836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168578666 | ||||||||
| FaxNumber: | 7168578944 | ||||||||
| Practice Location | |||||||||
| Address1: | 6333 MAIN ST | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142215800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166301484 | ||||||||
| FaxNumber: | 7166301413 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2006 | ||||||||
| LastUpdateDate: | 09/21/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 180360-1 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0001X | 180360-1 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
ID Information
| ID | Type | State | Issuer | Description | 01592869 | 05 | NY | MEDICAID | 161000580 | 01 | NY | UNITED HEALTHCARE | OTHER | 00040387602 | 01 | NY | UNIVERA | OTHER | 000524475008 | 01 | NY | HEALTH NOW | OTHER | 0021748 | 01 | NY | GHI | OTHER | 2190409 | 01 | NY | IHA | OTHER | 161000580 | 01 | NY | NORTH AMERICAN PREFERRED | OTHER | 161000580 | 01 | NY | NOVA | OTHER | 161000580 | 01 | NY | EMPIRE | OTHER | 161000580 | 01 | NY | AETNA | OTHER |