Provider Demographics
NPI:1588975239
Name:KIM, EUN YOUNG (MD)
Entity type:Individual
Prefix:DR
First Name:EUN YOUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EUN YOUNG
Other - Middle Name:SYLVIA
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:984-215-4111
Mailing Address - Fax:
Practice Address - Street 1:781 AVENT FERRY RD STE 310
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7776
Practice Address - Country:US
Practice Address - Phone:919-552-8911
Practice Address - Fax:919-552-8955
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60662884207Q00000X
NC2025-01321207Q00000X
AZ48412207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2068157Medicaid
WA2068157Medicaid