National Provider Identifier

Wang Ki Kim, MD

Wang Ki Kim, MD is listed in the NPPES registry with a primary specialty of Psychiatry Physician in Gowanda, NY and a listed phone number of (716) 532-9202.

NPI 1649345349Gowanda, NYPsychiatry Physician

Profile Overview

NPI
1649345349
Provider Type
Individual
Primary Specialty
Psychiatry Physician
Enumeration Date
November 21, 2006
Last Updated
May 24, 2011

Practice Location

  • 100 Memorial Drive
  • Gowanda, NY 14070

Phone: (716) 532-9202

Mailing Address

  • 54425 Lakeshore Road
  • Hamburg, NY 14075

Specialties

  • Psychiatry Physician (2084P0800X)
  • Addiction Medicine (Psychiatry & Neurology) Physician (2084A0401X)
Full Record
NPI
1649345349
Entity Type
Individual
Last Name
Kim
First Name
Wang
Middle Name
Ki
Credential
MD
Mailing Street Address
54425 Lakeshore Road
Mailing City
Hamburg
Mailing State
NY
Mailing ZIP Code
14075
Mailing Country
US
Mailing Phone
(716) 627-3776
Mailing Fax
(716) 627-1162
Practice Street Address
100 Memorial Drive
Practice City
Gowanda
Practice State
NY
Practice ZIP Code
14070
Practice Country
US
Practice Phone
(716) 532-9202
Enumeration Date
November 21, 2006
Last Updated
May 24, 2011
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Psychiatry Physician (2084P0800X), Addiction Medicine (Psychiatry & Neurology) Physician (2084A0401X)
Other Identifiers
69440206 (NY, Lionel R John Contract He), 00020290301 (NY, Univera), 1505718 (NY, Independent Health), 5074651 (NY, Blue Cross), 005074651 (NY, Community Blue), 074651 (NY, Blue Shield), 1042076 (NY, Fidelis Care), 69440206 (NY, Cattaraugus Indian Reserv), 01429390 (NY)