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NPI Code Detail

MEDICARE: SEUNG W. KIM M.D.

MEDICARE: SEUNG W. 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
1207LP2900XPain Medicine (Anesthesiology) Physician2009-01151NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11534EOTHERBCBS NC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205032984
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEUNG W. KIM M.D.
Provider Business Mailing Address
First Line : 7780 BRIER CREEK PKWY
Second Line : STE. 200
City : RALEIGH
State : NC
Zip : 27617-7849
Country : US
Telephone Number : 919-596-3400
Fax Number : 919-596-3499
Provider Business Practice Location Address
First Line : 7780 BRIER CREEK PKWY
Second Line : SUITE 200
City : RALEIGH
State : NC
Zip : 27617-7869
Country : US
Telephone Number : 919-596-3400
Fax Number : 919-596-3499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2007
Last Update Date : 04/03/2017

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