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General NPI Number Information
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NPI Number | 1548363740
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Entity Type | Organization
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Legal Business Name | AMBULATORY ANESTHESIA SERVICES INC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 10730 MAIN STREET
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City | FAIRFOX
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State | VA
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Zip | 22030
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Country | US
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Telephone | 301-317-0020
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Fax | 301-317-0028
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Provider Business Mailing Address
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Address Line | 10449 WHITE GRANITE DR UNIT 129
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City | OAKTON
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State | VA
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Zip | 22124-8005
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Country | US
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Telephone | 703-863-8767
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ANDREW KIM
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Credential | MD
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Telephone | 703-863-8767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | VA
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