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General NPI Number Information
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NPI Number | 1346380623
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Entity Type | Individual
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Provider Name | HEIDI H KONG M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 10 CENTER DR BUILDING 10, ROOM 12N238
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-402-7452
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CENTER DR MSC 1908
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City | BETHESDA
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State | MD
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Zip | 20892
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | D0062698
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License Number State | MD
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