Provider Demographics
NPI:1932559747
Name:KIM, JUN MAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUN MAN
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1364 CLIFTON RD NE STE BG03
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1059
Mailing Address - Country:US
Mailing Address - Phone:404-778-2626
Mailing Address - Fax:404-712-7908
Practice Address - Street 1:1364 CLIFTON RD NE STE BG03
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1802
Practice Address - Country:US
Practice Address - Phone:404-778-2626
Practice Address - Fax:404-712-7908
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA911912085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology