Individual
MR. JINAHN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 SATELLITE BLVD., BLDG. 700, STE 701A, SUWANEE, GA 30024-4651
(678) 417-1255
(678) 417-1258
Mailing address
1325 SATELLITE BLVD., BLDG. 700, STE 701A, SUWANEE, GA 30024-4651
(678) 417-1255
(678) 417-1258
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
054442
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511I110297
MEDICARE PTAN
—
05
—
921315018A
—
GA
Enumeration date
05/09/2006
Last updated
08/17/2017
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