Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ryan Dong-Woo Kim

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1942950753

Ryan Dong-Woo Kim is an Internal Medicine in Lawrenceville, Georgia. Qualified in 2022, 4 years ago. Practices with The Southeast Permanente Medical Group, a 826-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
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Practice location Address checks out

1000 Medical Center Blvd Fl
Lawrenceville, GA 30046-7694
Phone: (678) 312-4041
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1942950753
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 25, 2022
Last updated in NPPESMarch 25, 2022
Certification dateMarch 25, 2022
Mailing address1000 Medical Center Blvd Fl, Lawrenceville, GA 30046-7694

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice The Southeast Permanente Medical Group — 826 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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