Provider Demographics
NPI:1205034527
Name:KIM-SHAPIRO, JUNG WHA (MD)
Entity Type:Individual
Prefix:DR
First Name:JUNG
Middle Name:WHA
Last Name:KIM-SHAPIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-5075
Mailing Address - Country:US
Mailing Address - Phone:336-224-1482
Mailing Address - Fax:336-236-4684
Practice Address - Street 1:10 MEDICAL PARK DR
Practice Address - Street 2:SUITE 5
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-5075
Practice Address - Country:US
Practice Address - Phone:336-224-1482
Practice Address - Fax:336-236-4684
Is Sole Proprietor?:No
Enumeration Date:2007-07-08
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-00166207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5909821Medicaid
NC31069BMedicare UPIN
NC2023067Medicare PIN