Basic Information
| Provider Information | |||||||||
| NPI: | 1023301801 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KIM | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 833 ST VINCENT'S DRIVE | ||||||||
| Address2: | SUITE 300 POB III | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352051606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059394500 | ||||||||
| FaxNumber: | 2059394519 | ||||||||
| Practice Location | |||||||||
| Address1: | 833 SAINT VINCENTS DR | ||||||||
| Address2: | SUITE 300 POB III | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352051606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059394500 | ||||||||
| FaxNumber: | 2059394519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2011 | ||||||||
| LastUpdateDate: | 03/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD32579 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.