Individual
JISOO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
517 MOYE BLVD, GREENVILLE, NC 27834-2849
(252) 744-2393
(252) 744-0013
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2022-02860
NC
Other
Enumeration date
04/27/2018
Last updated
09/24/2024
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