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NPI Code Detail

MEDICARE: DR. MICHAEL K. KIM M.D.

MEDICARE: DR. MICHAEL K. KIM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0101229869VA

General Provider Information

NPI Number : 1285836189
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL K. KIM M.D.
Provider Business Mailing Address
First Line : 5000 COX RD
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-9263
Country : US
Telephone Number : 804-968-5700
Fax Number : 804-217-7991
Provider Business Practice Location Address
First Line : 60 PROSPERITY LN
Second Line :
City : STAFFORD
State : VA
Zip : 22556-4605
Country : US
Telephone Number : 757-303-9475
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2007
Last Update Date : 02/15/2022

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