Individual
SHAWN S. KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3473 SATELLITE BLVD, SUITE 108 NORTH, DULUTH, GA 30096-8690
(770) 864-5510
(770) 864-5398
Mailing address
3473 SATELLITE BLVD, SUITE 108 NORTH, DULUTH, GA 30096-8690
(770) 864-5510
(770) 864-5398
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200401084
NC
207R00000X
Internal Medicine Physician
Primary
60393
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I112967
PTAN
GA
05
—
642674634A
—
GA
05
—
8113721
—
NC
Enumeration date
01/13/2006
Last updated
12/15/2011
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