Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Chang Soo Kim, MD

Individual provider Family Medicine Physician · NPI 1215149554

Dr. Chang Soo Kim, MD is a Family Practice in Duluth, Georgia. Qualified in 1989, 37 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
37
Licensed in
GA
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3590 Peachtree Industrial Blvd
Duluth, GA 30096-4817
Phone: (770) 614-9799
Fax: (770) 614-9789
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 59806 (GA)

Record details

NPI number1215149554
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 7, 2007
Last updated in NPPESJune 22, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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