MEDICARE: VICTOR B 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	200400532	NC
2	208600000X	Surgery Physician	200400532	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356305833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR B KIM M.D.

Provider Business Mailing Address
First Line	:	PO BOX 896206
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28289-6206
Country	:	US
Telephone Number	:	252-633-6730
Fax Number	:	252-633-6740

Provider Business Practice Location Address
First Line	:	960 NEWMAN RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5200
Country	:	US
Telephone Number	:	252-633-6730
Fax Number	:	252-633-6740

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	03/17/2017

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Directions to “ VICTOR B KIM M.D.” Practice Location

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