Provider Demographics
NPI:1598903569
Name:MURPHY, KYUNG-MI LIM (MD)
Entity Type:Individual
Prefix:DR
First Name:KYUNG-MI
Middle Name:LIM
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KYUNG-MI
Other - Middle Name:
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 800
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-0800
Mailing Address - Country:US
Mailing Address - Phone:804-695-0305
Mailing Address - Fax:804-695-0804
Practice Address - Street 1:7363 WALKER AVE
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-6119
Practice Address - Country:US
Practice Address - Phone:804-695-0305
Practice Address - Fax:804-695-0804
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101226326208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1598903569Medicaid