KI WAN KIM (NPI# 1356490734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356490734 |
| Entity Type | Individual |
| Full Name | KI WAN KIM |
| Credential | MD |
| Practice Address |
61 Whitcher St Ne Ste 4120 Marietta GA 30060 |
| Mailing Address |
61 Whitcher St Ne Ste 4120 Marietta GA 30060-1179 |
| Practice Telephone | 7704249732 |
| Mailing Telephone | 7704249732 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2019-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | A90695 | CA | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 82757 | GA | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 036127784 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2650 Ridge Ave, Walgreen Building Suite 3507, Evanston, IL 602011718 | 8475702868 | |
| 315 Boulevard Ne Ste 500, Atlanta, GA 30312 | 7704249732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689961120 | Ki Wan Kim | Dentist | 3601 Vista Way, Suite #202, Oceanside, CA 92056-4559 | 2011-07-05 |
| Street Address |
61 WHITCHER ST NE STE 4120 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346282928 | Gerald Andrew Helms | Surgery | 61 Whitcher St Ne Ste 4120, Marietta, GA 30060-1179 | 2006-06-11 |
| 1437604642 | Jennifer June Mccall | Nurse Practitioner | 61 Whitcher St Ne Ste 4120, Marietta, GA 30060-1179 | 2016-08-17 |
| 1982075958 | Amanda M. Haas | Physician Assistant | 61 Whitcher St Ne Ste 4120, Marietta, GA 30060 | 2015-10-15 |
| 1114323573 | Kristin Laine Rogers | Physician Assistant | 61 Whitcher St Ne Ste 4120, Marietta, GA 30060-1179 | 2014-11-13 |
| 1639441405 | Nathan Westercamp | Physician Assistant | 61 Whitcher St Ne Ste 4120, Marietta, GA 30060 | 2012-02-08 |
| 1588794937 | Wellstar Thoracic Surgery Associates, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 61 Whitcher St Ne Ste 4120, Marietta, GA 30060-1179 | 2007-03-06 |
| 1194895482 | Bina Mohanbhai Bhakta | Physician Assistant | 61 Whitcher St Ne Ste 4120, Marietta, GA 30060-1179 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245262112 | Molly Mcafee | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 400 Matthew St Ste 401, Marietta, OH 45750-1656 | 2006-07-07 |
| 1780666719 | William Rodger Mayfield | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 61whitcher St Ne, Suite 4120, Marietta, GA 30060-1155 | 2005-11-16 |
| 1467885863 | Wellstar Medical Group, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 61 Whitcher St Ne, Suite 4100, Marietta, GA 30060-1176 | 2013-08-21 |
| 1760788814 | Wellstar Medical Group, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 61 Whitcher St Ne, Suite 4120, Marietta, GA 30060-1176 | 2011-02-08 |
| 1619137312 | Harrell Lightfoot | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 61 Whitcher Street, Suite 4100, Marietta, GA 30060-1181 | 2008-06-16 |
| 1831377092 | Theresa D. Luu | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 61 Whitcher St Ne, Suite 4120, Marietta, GA 30060-1176 | 2008-02-08 |
| 1922282474 | Richard J. Myung | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 61 Whitcher St Ne, Suite 4100, Marietta, GA 30060-1176 | 2007-12-19 |
| 1588794937 | Wellstar Thoracic Surgery Associates, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 61 Whitcher St Ne Ste 4120, Marietta, GA 30060-1179 | 2007-03-06 |
| 1851480412 | Vinod H Thourani | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 55 Whitcher St Ne, Suite 270, Marietta, GA 30060-1155 | 2006-10-12 |
| 1831288430 | Daniel L Miller | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 61 Whitcher St Ne, Suite 4120, Marietta, GA 30060-1176 | 2006-10-12 |
| Find all providers in MARIETTA | ||||
Please comment or provide details below to improve the information on KI WAN KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.