Provider Demographics
NPI:1841859014
Name:KIM, DANIEL YOUNGHOE (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:YOUNGHOE
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3890 REDWINE RD SW STE 100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-5583
Mailing Address - Country:US
Mailing Address - Phone:404-344-0059
Mailing Address - Fax:
Practice Address - Street 1:3890 REDWINE RD SW STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-5583
Practice Address - Country:US
Practice Address - Phone:404-344-0059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA92605207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine