Individual
DR. STEPHEN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
61 WHITCHER ST NE, SUITE 1100, MARIETTA, GA 30060-1176
(770) 422-3290
(770) 422-0287
Mailing address
61 WHITCHER ST NE, SUITE 1100, MARIETTA, GA 30060-1176
(770) 422-3290
(770) 422-0287
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
063362
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
939355713A
—
GA
05
—
939355713B
—
GA
05
—
939355713C
—
GA
01
—
P00874274
MEDICARE RAILROAD
GA
Enumeration date
05/11/2009
Last updated
02/20/2012
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