Provider Demographics
NPI:1174505945
Name:COMBS, KIM H (MD)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:H
Last Name:COMBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 TATE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1111
Mailing Address - Country:US
Mailing Address - Phone:434-846-7374
Mailing Address - Fax:434-846-1910
Practice Address - Street 1:2019 TATE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1111
Practice Address - Country:US
Practice Address - Phone:434-846-7374
Practice Address - Fax:434-846-1910
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
7469527OtherAETNA
VA005640032Medicaid
CF1947OtherMEDICARE RAILROAD GROUP #
0101872OtherUNITED HEALTHCARE GROUPS
226882OtherANTHEM
080143060OtherMEDICARE RAILROAD PROVIDER NUMBER
VA1184797789OtherCVFP SITE NPI
VA1528155892OtherCVFP CORPORATE NPI
170847OtherSOUTHERN HEALTH
VAC03658OtherMEDICARE GROUP #
170847OtherSOUTHERN HEALTH
VAG97575Medicare UPIN
VA005640032Medicaid