Provider Demographics
NPI:1851423438
Name:KIM, DANIEL SANGYOL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SANGYOL
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 MERIDIAN MARKS RD NE
Mailing Address - Street 2:SUITE 570
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1654
Mailing Address - Country:US
Mailing Address - Phone:404-601-7290
Mailing Address - Fax:
Practice Address - Street 1:5455 MERIDIAN MARKS RD NE
Practice Address - Street 2:SUITE 570
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1654
Practice Address - Country:US
Practice Address - Phone:404-601-7290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-10
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0598072086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery