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General NPI Number Information
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NPI Number | 1861765083
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Entity Type | Individual
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Provider Name | DAVID DAE WE KIM D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/18/2012
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3333 SILAS CREEK PKWY
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3013
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Country | US
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Telephone | 336-718-9080
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Fax | 336-718-9085
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone |
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Fax |
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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 | 34013505
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License Number State | OH
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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 | 2024-03137
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License Number State | NC
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