MEDICARE: DR. PAUL S KIM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	20000490	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	2280204B	OTHER	NC	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1259C	OTHER	NC	BLUE CROSS BLUE SHIELD
2	56142	OTHER	NC	COMMERCIAL INSURANCE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114923299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL S KIM M.D.

Provider Business Mailing Address
First Line	:	PO BOX 38
Second Line	:
City	:	FLETCHER
State	:	NC
Zip	:	28732-0038
Country	:	US
Telephone Number	:	828-687-9993
Fax Number	:	828-687-2491

Provider Business Practice Location Address
First Line	:	3159 HENDERSONVILLE ROAD
Second Line	:
City	:	FLETCHER
State	:	NC
Zip	:	28732
Country	:	US
Telephone Number	:	828-687-9993
Fax Number	:	828-687-2491

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	01/20/2010

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Directions to “ DR. PAUL S KIM M.D.” Practice Location

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