Provider Demographics
NPI:1467671024
Name:KIM, MIN HUI (MD)
Entity Type:Individual
Prefix:
First Name:MIN HUI
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH MIN HUI
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:388 BULLSBORO DR STE 220
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-1069
Mailing Address - Country:US
Mailing Address - Phone:916-741-7115
Mailing Address - Fax:
Practice Address - Street 1:600 CELEBRATE LIFE PARKWAY
Practice Address - Street 2:DEPARTMENT OF BREAST SURGICAL ONCOLOGY
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265
Practice Address - Country:US
Practice Address - Phone:916-741-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301084371208600000X
CAA125773208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery