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Contact Information

CHANG SOO KIM, MD
3590 PEACHTREE INDUSTRIAL BLVD
DULUTH, GA30096-4817
 Phone: 770-614-9799
 Fax: 770-614-9789
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for CHANG SOO KIM · (Male)

NPI # 1215149554
Status Active
Credentials MD
Entity Individual
Enumeration date 05/07/2007
Last updated 06/22/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # 59806
Hospital affiliation(s)
  • NORTHSIDE HOSPITAL FORSYTH - (Acute Care)
    1200 NORTHSIDE FORSYTH DRIVE
    CUMMING, GA 30041
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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