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General NPI Number Information
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NPI Number | 1235383464
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Entity Type | Individual
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Provider Name | MYUNG MI KIM M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 1025 MOREHEAD MEDICAL DR SUITE 300
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City | CHARLOTTE
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State | NC
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Zip | 28204-2963
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Country | US
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Telephone | 704-355-1813
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Fax | 704-355-5980
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Provider Business Mailing Address
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Address Line | PO BOX 601372
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City | CHARLOTTE
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State | NC
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Zip | 28260-1372
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Country | US
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Telephone | 704-355-1813
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Fax | 704-355-5980
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 1060118
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2013-00050
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License Number State | NC
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