Provider Demographics
NPI:1487768818
Name:KIM, LAWRENCE THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:THOMAS
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:170 MANNING DR
Mailing Address - Street 2:CB #7213
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7213
Mailing Address - Country:US
Mailing Address - Phone:919-966-5221
Mailing Address - Fax:919-966-8806
Practice Address - Street 1:170 MANNING DR
Practice Address - Street 2:CB #7213
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7213
Practice Address - Country:US
Practice Address - Phone:919-966-5221
Practice Address - Fax:919-966-8806
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH4464208600000X
NC2013-02274208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP085A2808Medicaid
ARG01178Medicare UPIN
ARKI085A280Medicare ID - Type Unspecified