Healthcare Provider Details

I. General information

NPI: 1548180524
Provider Name (Legal Business Name): DANIEL KIM STONEKING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20611 GOSHEN RD
GAITHERSBURG MD
20879-1603
US

IV. Provider business mailing address

20611 GOSHEN RD
GAITHERSBURG MD
20879-1603
US

V. Phone/Fax

Practice location:
  • Phone: 360-430-7521
  • Fax:
Mailing address:
  • Phone: 360-430-7521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR269621
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: