Basic Information
| Provider Information | |||||||||
| NPI: | 1194031542 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAM | ||||||||
| FirstName: | KYUNG | ||||||||
| MiddleName: | HUN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | MUNGER PAVILION, ROOM 253 | ||||||||
| Address2: | NEW YORK MEDICAL COLLEGE, DEPARTMENT OF MEDICINE | ||||||||
| City: | VALHALLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3475330912 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3901 RAINBOW BLVD - MS1045 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135881559 | ||||||||
| FaxNumber: | 9139456403 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2010 | ||||||||
| LastUpdateDate: | 08/07/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | 9408197 | KS | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.