Individual
KI WAN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
61 WHITCHER ST NE STE 4120, MARIETTA, GA 30060
(770) 424-9732
Mailing address
61 WHITCHER ST NE STE 4120, MARIETTA, GA 30060-1179
(770) 424-9732
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A90695
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036127784
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
82757
GA
Other
Enumeration date
01/09/2007
Last updated
10/16/2019
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