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NPI Code Detail

MEDICARE: DR. GEORGE GI-MIN KIM M.D.

MEDICARE:  DR. GEORGE GI-MIN 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
1207R00000XInternal Medicine Physician9700614NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00243621OTHERNCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31061YOTHERNCBLUE CROSS BLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508906132
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE GI-MIN KIM M.D.
Provider Business Mailing Address
First Line : PO BOX 219
Second Line :
City : LYNN
State : NC
Zip : 28750-0219
Country : US
Telephone Number : 828-859-7659
Fax Number : 828-859-2470
Provider Business Practice Location Address
First Line : 2536 LYNN RD
Second Line : SUITE B
City : TRYON
State : NC
Zip : 28782-7875
Country : US
Telephone Number : 828-859-7659
Fax Number : 828-859-2470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 04/22/2008

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Directions to “ DR. GEORGE GI-MIN KIM M.D.” Practice Location

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