Chang Soo Kim (NPI# 1215149554, PAC ID# 7416028451) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1215149554 |
| PAC ID by PECOS | 7416028451 |
| Professional Enrollment ID | I20080618000309 |
| Full Name | Chang Soo Kim |
| Address |
3590 Peachtree Industrial Blvd Duluth GA 30096-4817 |
| Gender | M |
| Graduation Year | 1989 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110087 | GWINNETT MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3590 Peachtree Industrial Blvd, Duluth, GA 30096-4817 |
| Street Address |
3590 PEACHTREE INDUSTRIAL BLVD |
| City | DULUTH |
| State | GA |
| Zip | 30096-4817 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven Mark Sommer | Chiropractic | 3699 Duluth Park Lane, Suite 110, Duluth, GA 30096 | |
| Janet S Waldt | Occupational Therapy | Peachtree Orthopaedic Clinic Pa | 3870 Pleasant Hill Road, Suite 1, Duluth, GA 30096 |
| Richard Reid Maxa | Internal Medicine | Maxa Internal Medicine Associates PC | 3505 Duluth Park Lane, Bldg 4 Suite 400, Duluth, GA 30096 |
| Otis Winston Clark | Physical Therapy | Pt Solutions of Acworth LLC | 3455 Peachtree Indus Blvd, Suite 130, Duluth, GA 30096 |
| Cori Folkes Harrell | Nurse Practitioner | Maxa Internal Medicine Associates PC | 3505 Duluth Park Lane, Bldg 4 Suite 400, Duluth, GA 30096 |
| Benigno B Bobon | Internal Medicine | Maxa Internal Medicine Associates PC | 3505 Duluth Park Lane, Bldg 4 Suite 400, Duluth, GA 30096 |
| Joel Kent Phillips | Physician Assistant | Maxa Internal Medicine Associates PC | 3505 Duluth Park Lane, Bldg 4 Suite 400, Duluth, GA 30096 |
| Sherry E Johnson | Occupational Therapy | Peachtree Orthopaedic Clinic Pa | 3870 Pleasant Hill Road, Suite 1, Duluth, GA 30096 |
| Danielle R Mcgee | Physical Therapy | Peachtree Orthopaedic Clinic Pa | 3870 Pleasant Hill Road, Suite 1, Duluth, GA 30096 |
| Laura E Lashley | Nurse Practitioner | Maxa Internal Medicine Associates PC | 3505 Duluth Park Lane, Bldg 4 Suite 400, Duluth, GA 30096 |
| Find all physicians in zip 30096 | |||
| City | DULUTH |
| Zip Code | 30096 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | DULUTH + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Chang Soo Kim.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.