Healthcare Provider Details

I. General information

NPI: 1417057217
Provider Name (Legal Business Name): HEI-JUNG C. KIM, M.D., L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 MARYLAND AVE APT 506
ROCKVILLE MD
20850-2374
US

IV. Provider business mailing address

44 MARYLAND AVE APT 506
ROCKVILLE MD
20850-2374
US

V. Phone/Fax

Practice location:
  • Phone: 301-424-7700
  • Fax: 301-424-0305
Mailing address:
  • Phone: 301-424-7700
  • Fax: 301-424-0305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09979
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD32686
License Number StateMD

VIII. Authorized Official

Name: DR. HEI-JUNG C KIM
Title or Position: DIRECTOR/OWNER
Credential: M.D.
Phone: 301-424-7700