Provider Demographics
NPI:1114923299
Name:KIM, PAUL S (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SUNG
Other - Middle Name:U
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-0038
Mailing Address - Country:US
Mailing Address - Phone:828-687-9993
Mailing Address - Fax:828-687-2491
Practice Address - Street 1:3159 HENDERSONVILLE ROAD
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732
Practice Address - Country:US
Practice Address - Phone:828-687-9993
Practice Address - Fax:828-687-2491
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20000490207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1259COtherBLUE CROSS BLUE SHIELD
NC56142OtherCOMMERCIAL INSURANCE
NC2280204BOtherMEDICARE
NC891259CMedicaid
NC2280204BOtherMEDICARE