Individual
DAVID D KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
047336
GA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
047336
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000792932F
MEDICAID - STATESBORO
GA
01
—
000792932H
MEDICAID- VIDALIA
GA
05
—
00792932B
—
GA
01
—
00792932G
MEDICAID - SAVANNAH
GA
01
—
1508805052
MEDICARE RAILROAD
GA
01
—
782177
BLUE CROSS BLUE SHIELD
—
01
—
GPA977
MEDICAID GRP. SAV
SC
Enumeration date
06/06/2006
Last updated
06/10/2024
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