Physician Compare National (NPI:1881786820)

HEALTHCARE PROVIDER: KIMBERLEY B GOH MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1881786820
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274797410
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120619000455
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GOH
	Individual professional last name
Provider First Name	KIMBERLEY
	Individual professional first name
Provider Middle Name	BING-CHU
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PLASTIC AND RECONSTRUCTIVE SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PLASTIC AND RECONSTRUCTIVE SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	4610 OLEANDER DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	MYRTLE BEACH
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	295775752
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	420085
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GRAND STRAND REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	420098
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	TIDELANDS WACCAMAW COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y