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General NPI Number Information
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NPI Number | 1336341239
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Entity Type | Individual
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Provider Name | ANDREW SEUNG-EUN KIM MD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2007
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 5875 BREMO RD STE 500
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City | RICHMOND
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State | VA
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Zip | 23226-1928
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Country | US
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Telephone | 804-297-3055
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Fax | 804-297-3056
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Provider Business Mailing Address
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Address Line | PO BOX 936952
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City | ATLANTA
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State | GA
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Zip | 31193-6952
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 0101267913
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License Number State | VA
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