MEDICARE: DR. EDWIN H 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	208000000X	Pediatrics Physician	2008-00846	NC
2	207K00000X	Allergy & Immunology Physician	2008-00846	NC

General Provider Information

NPI Number	:	1659577070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWIN H KIM M.D.

Provider Business Mailing Address
First Line	:	3004C MARY ELLEN JONES BLDG
Second Line	:	116 MANNING DR, CB 7231
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514
Country	:	US
Telephone Number	:	919-537-3193
Fax Number	:

Provider Business Practice Location Address
First Line	:	6013 FARRINGTON RD
Second Line	:	SUITE 300
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-8172
Country	:	US
Telephone Number	:	919-962-4824
Fax Number	:	919-493-0474

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

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	08/16/2021

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