Provider Demographics
NPI:1417110784
Name:KIM, HYEONG JOONG (MD)
Entity type:Individual
Prefix:DR
First Name:HYEONG
Middle Name:JOONG
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE STE 1550
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2253
Mailing Address - Country:US
Mailing Address - Phone:404-686-2505
Mailing Address - Fax:404-686-4840
Practice Address - Street 1:550 PEACHTREE ST NE STE 1550
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2253
Practice Address - Country:US
Practice Address - Phone:404-686-2505
Practice Address - Fax:404-686-4840
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA102780207RP1001X, 207RH0002X, 207R00000X, 207RC0200X, 207RH0002X, 207RP1001X
MDD87044207RH0002X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1417110784Medicaid
NC19D8KOtherBCBS NC
NCNCP569AMedicare PIN