DAVID DAEWHAN KIM M.D.
NPI 1609940113
Physical Medicine & Rehabilitation - Pain Medicine in Detroit, MI

NPI Status: Active since November 17, 2006

Contact Information

HENRY FORD HEALTH SYSTEM
2799 WEST GRAND BOULEVARD
DETROIT, MI
ZIP 48202
Phone: (313) 916-2436

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  • Individual
  • Male
  • Years of Experience 36
  • Physical Medicine & Rehabilitation
  • Pain Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About DAVID KIM

This page provides the complete NPI Profile along with additional information for David Kim, a provider established in Detroit, Michigan with a medical specialization in Physical Medicine & Rehabilitation, focusing in pain medicine and more than 36 years of experience. He graduated from University Of Maryland School Of Medicine in 1990. The healthcare provider is registered in the NPI registry with number 1609940113 assigned on November 2006. The practitioner's primary taxonomy code is 2081P2900X with license number 4301066691 (MI). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1609940113
Provider Name
DAVID DAEWHAN KIM M.D.
Gender
Male
Entity Type
Individual
Location Address
HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD DETROIT, MI 48202
Location Phone
(313) 916-2436
Mailing Address
HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD DETROIT, MI 48202
Mailing Phone
(313) 916-2436
Medical School Name
UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE
Graduation Year
1990
Is Sole Proprietor?
No
Enumeration Date
11-17-2006
Last Update Date
05-31-2018
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Medicine & Rehabilitation Pain Medicine

Taxonomy Code
2081P2900X
Type
Allopathic & Osteopathic Physicians
License No.
4301066691
License State
MI
Taxonomy Description
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208100000XAllopathic & Osteopathic Physicians

Physical Medicine & Rehabilitation

4301066691 (MI)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Clear Silver - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Blue Cross� Preferred HMO Bronze Extra - HMO
  • Blue Cross� Preferred HMO Bronze Saver HSA - HMO
  • Blue Cross� Preferred HMO Bronze Secure - HMO
  • Blue Cross� Preferred HMO Gold - HMO
  • Blue Cross� Preferred HMO Gold Extra - HMO
  • Blue Cross� Preferred HMO Silver - HMO
  • Blue Cross� Preferred HMO Silver Extra - HMO
  • Blue Cross� Preferred HMO Silver Saver - HMO
  • Blue Cross� Preferred HMO Value - HMO
  • Blue Cross� Select HMO Bronze Extra - HMO
  • Blue Cross� Select HMO Bronze Saver HSA - HMO
  • Blue Cross� Select HMO Bronze Secure - HMO
  • Blue Cross� Select HMO Silver - HMO
  • Blue Cross� Select HMO Silver Extra - HMO
  • Blue Cross� Select HMO Silver Saver - HMO
  • Blue Cross� Select HMO Value - HMO
  • Blue Cross� Premier PPO Bronze Extra - PPO
  • Blue Cross� Premier PPO Bronze HSA - PPO
  • Blue Cross� Premier PPO Bronze Secure - PPO
  • Blue Cross� Premier PPO Gold - PPO
  • Blue Cross� Premier PPO Gold Extra - PPO
  • Blue Cross� Premier PPO Silver - PPO
  • Blue Cross� Premier PPO Silver Extra - PPO
  • Blue Cross� Premier PPO Silver Saver HSA - PPO
  • Blue Cross� Premier PPO Value - PPO
  • Bronze First - HMO
  • Bronze First Adult Vision & Fitness - HMO
  • Diabetes Gold - HMO
  • Diabetes Gold Adult Vision & Fitness - HMO
  • Diabetes Silver - HMO
  • Diabetes Silver Adult Vision & Fitness - HMO
  • Gold - HMO
  • Gold Adult Vision & Fitness - HMO
  • HDHP Preventive Silver - HMO
  • Healthy Heart Gold - HMO
  • Healthy Heart Gold Adult Vision & Fitness - HMO
  • Healthy Heart Silver - HMO
  • Healthy Heart Silver Adult Vision & Fitness - HMO
  • Low Premium Silver - HMO
  • Low Premium Silver Adult Vision & Fitness - HMO
  • Silver - HMO
  • Silver Adult Vision & Fitness - HMO
  • MHP Bronze - HMO
  • MHP Bronze Saver (Expanded) - HMO
  • MHP Expanded Bronze Standard - HMO
  • MHP Gold - HMO
  • MHP Gold Standard - HMO
  • MHP Silver Exchange - HMO
  • MHP Silver Exchange Rewards - HMO
  • MHP Silver Standard - HMO
  • MHP Young Adult/Catastrophic - HMO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with First 4 Primary Care Visits Free - HMO
  • Silver 8 - HMO
  • MyPriority Balanced Silver - HMO
  • MyPriority Premier Silver - HMO
  • MyPriority Standard Bronze - HMO
  • MyPriority Standard Bronze - Travel - HMO
  • MyPriority Standard Gold - HMO
  • MyPriority Standard Silver - HMO
  • MyPriority Standard Silver - Travel - HMO
  • MyPriority Value Bronze - HMO
  • MyPriority Value Bronze HSA - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
DK066691OTHER (01)CHAMPUS-CHAMPUS
DK066691OTHER (01)COMMERCIAL-COMMERCIAL NUMBER
250Q260840OTHER (01)BLUE CROSS-BLUE CROSS
447344610MEDICAID (05)MI 

Medicare Participation & PECOS Enrollment Status

David Kim is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

David Kim is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7719035047

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20090424000491

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 22 times for 16 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

This service was performed 18 times for 13 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 22 times for 20 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 250 times for 126 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 18 times for 16 patients

Fluoroscopic guidance for needle placement

Fluoroscopic guidance for needle placement is a medical procedure that uses a special X-ray technology to help accurately place a needle in the body. It's often used in biopsies, injections or other treatments to ensure precision and safety.

This service was performed 24 times for 18 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 30 times for 25 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

This service was performed 23 times for 17 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 35 times for 25 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 43 times for 30 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 36 times for 36 patients

Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed ex

A remote in-home visit is a service for established patients part of a specific Medicare-approved program. It involves a thorough evaluation and management of your health condition. This service includes at least 2 of 3 key components: a detailed medical history review, a comprehensive examination, or a complex decision-making process.

This service was performed 15 times for 13 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

This service was performed 60 times for 42 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. David Kim is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
HENRY FORD HEALTH HOSPITAL2799 W GRAND BLVD
DETROIT, MI 48202
(313) 916-2600Acute Care Hospitals
HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL6777 WEST MAPLE ROAD
WEST BLOOMFIELD, MI 48322
(248) 325-1000Acute Care Hospitals

Reviews for DAVID DAEWHAN KIM M.D.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1609940113
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2609184012
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 0 + 9 + 1 + 8 + 4 + 0 + 1 + 2 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1609940113 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1336147461 JOSEPH LAWRENCE LELLI M.D.
Individual
Surgery (Pediatric Surgery)HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-2436
1124015565 CHRISTINA MUBARAK SHANTI M.D.
Individual
Surgery (Pediatric Surgery)HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-9106
1023097300 MEHSATI HERAWI M.D., PH.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-2436
1215900592 JOSEPH C. WON M.D.
Individual
Internal Medicine (Medical Oncology)HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-2436
1275509267 JAMES JOSEPH ANDONIAN M.D.
Individual
Preventive Medicine (Occupational Medicine)HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-9106
1285693804 RAECHELE C. GATHERS M.D.
Individual
DermatologyHENRY FORD HEALTH SYSTEM 3031 WEST GRAND BLVD.
DETROIT, MI 48202
(313) 916-2454
1770520272 KAVITHA CHINTALA M.D.
Individual
Pediatrics (Pediatric Cardiology)HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-9106
1255340105 ANDREW N. RUSSMAN D.O.
Individual
Psychiatry & Neurology (Neurology)HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-9106
1861401622 MOHAMED A. ELSHAIKH M.D.
Individual
Radiology (Radiation Oncology)HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-2436
1427165679 RAYMOND D. HOBBS M.D.
Individual
Internal MedicineHENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-9106
1710065842 HENRY W. LIM M.D.
Individual
Dermatology (Clinical & Laboratory Dermatological Immunology)HENRY FORD HEALTH SYSTEM 3031 WEST GRAND BLVD.
DETROIT, MI 48202
(313) 916-2454
1700964830 TOR A. SHWAYDER M.D.
Individual
Dermatology (Pediatric Dermatology)HENRY FORD HEALTH SYSTEM 3031 WEST GRAND BLVD.
DETROIT, MI 48202
(313) 916-2454
1629157052 NICOLE C. ROCCO M.D.
Individual
Internal MedicineHENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-9100
1619041126 SUSAN P. SCHOOLEY M.D.
Individual
Family MedicineHENRY FORD HEALTH SYSTEM ONE FORD PLACE 2C
DETROIT, MI 48202
(313) 874-5379
1164596672 STEPHANIE A. STOKES-BUZZELLI M.D.
Individual
Emergency MedicineHENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-2436
1881768398 CHRISTOPHER A. LEWANDOWSKI M.D.
Individual
Emergency MedicineHENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-9106
1417021924 CLIFFORD PATRICK LOECKNER M.D.
Individual
Emergency MedicineHENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-2436
1235203746 GERARD B. MARTIN M.D.
Individual
Emergency MedicineHENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-9106
1780758292 CHERYL J. MORDIS M.D.
Individual
AnesthesiologyHENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-9106
1306910823 TAHER VOHRA M.D.
Individual
Emergency MedicineHENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD
DETROIT, MI 48202
(313) 916-9106

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609940113, enumerated in the NPI registry as an "individual" on November 17, 2006

The provider is located at Henry Ford Health System 2799 West Grand Boulevard Detroit, Mi 48202 and the phone number is (313) 916-2436

The provider's speciality is Physical Medicine & Rehabilitation with taxonomy code 2081P2900X with a focus in Pain Medicine

The provider has more than 36 years of experience. He graduated from University Of Maryland School Of Medicine in 1990.

The provider might be accepting Accepts: Ambetter from Meridian, Ambetter Health, Blue Care. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The most common procedures or services performed by this practitioner are: Aspiration and/or injection of fluid from large joint, Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint, Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Fluoroscopic guidance for needle placement, Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level, Injection of lower or sacral spine facet joint using imaging guidance, second level, Injection of lower or sacral spine facet joint using imaging guidance, single level, Injection of substance into lower spine canal using imaging guidance, New patient office or other outpatient visit, 45-59 minutes, Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed ex and Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes.

The practitioner is affiliated to the following hospital(s): HENRY FORD HEALTH HOSPITAL and HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on November 17, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.