Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 83789 | GA |
N | 207RR0500X | Rheumatology | MD462403 | PA |
NPI | 1083960447 |
---|---|
Provider Name | Dr. Taik Kim |
First Address | Roswell, GA 30076-4910 |
Second Address | Roswell, GA 30076-4910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2012 |
Last Update Date | 06/01/2020 |