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Individual

KIHAE SHIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1800 10TH AVE, COLUMBUS, GA 31901-1529
(706) 571-1340
Mailing address
1800 10TH AVE, COLUMBUS, GA 31901-1529

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
84190
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/23/2018
Last updated
05/26/2021
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