Healthcare Provider Details

I. General information

NPI: 1750736880
Provider Name (Legal Business Name): VICTOR DAVID KIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2016
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CENTRAL DR
SANFORD NC
27330-4159
US

IV. Provider business mailing address

5221 PARAMOUNT PKWY STE 220
MORRISVILLE NC
27560-5490
US

V. Phone/Fax

Practice location:
  • Phone: 919-718-9512
  • Fax: 919-718-9516
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number2023-01294
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036149227
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: