Individual
MYUNG MI KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1025 MOREHEAD MEDICAL DR, SUITE 300, CHARLOTTE, NC 28204-2963
(704) 355-1813
(704) 355-5980
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 355-1813
(704) 355-5980
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1060118
IN
208600000X
Surgery Physician
Primary
2013-00050
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235383464
—
NC
05
—
200931090
—
IN
01
—
2013-00050
NC LICENSE
NC
01
—
IN1060118
STATE LICENSE
IN
05
—
NC1815
—
SC
Enumeration date
11/14/2008
Last updated
04/16/2014
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