Individual
JOHN PHILLIP KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
67 CREEKSIDE PARK CT, GREENVILLE, SC 29615-4810
(864) 242-4602
(864) 242-0129
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
17053
SC
207LP3000X
Pediatric Anesthesiology Physician
Primary
17053
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170530
—
SC
Enumeration date
06/15/2006
Last updated
05/06/2021
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