Provider Demographics
NPI:1023276029
Name:KIM, DANIEL L (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13225 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5480
Mailing Address - Country:US
Mailing Address - Phone:317-715-4863
Mailing Address - Fax:317-795-2047
Practice Address - Street 1:13225 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5480
Practice Address - Country:US
Practice Address - Phone:317-228-7000
Practice Address - Fax:317-228-2321
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2024-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01071893A207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201163920Medicaid
INP01214126OtherRR MEDICARE PTAN
266180184Medicare PIN