Individual
MIMI KIM SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CNM
Contact information
Practice address
10692 MEDLOCK BRIDGE RD STE 100A, JOHNS CREEK, GA 30097-8497
(404) 446-2496
Mailing address
2615 STONEHILL DR, CUMMING, GA 30041-9305
(678) 793-0089
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
RN213220
GA
367A00000X
Advanced Practice Midwife
Primary
RN213220
GA
Other
Enumeration date
07/15/2017
Last updated
02/17/2021
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