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General NPI Number Information
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NPI Number | 1447574934
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Entity Type | Individual
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Provider Name | SU HEE KIM MD
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Gender | Female
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Dates
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Enumeration Date | 03/26/2010
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 15 SPORTS MEDICINE DRIVE SUITE 100
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City | FISHERSVILLE
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State | VA
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Zip | 22939
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Country | US
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Telephone | 540-245-7180
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 388
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City | FISHERSVILLE
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State | VA
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Zip | 22939-0388
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Country | US
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Telephone | 540-245-7180
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Fax | 540-245-7181
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 0101253624
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License Number State | VA
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