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Individual

SELENA KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CAA

Contact information

Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(404) 616-1000
Mailing address
3140 CHESTNUT WOODS DR, ATLANTA, GA 30340-3245
(407) 810-3700

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
620-17
WI
367H00000X
Anesthesiologist Assistant
Primary
9537
GA

Other

Enumeration date
08/07/2019
Last updated
05/04/2026
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