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General NPI Number Information
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NPI Number | 1629658067
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Entity Type | Individual
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Provider Name | ELIANA HEEYUN KIM DO
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Gender | Female
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 12254 ROCKVILLE PIKE
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City | ROCKVILLE
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State | MD
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Zip | 20852-1608
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Country | US
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Telephone | 301-230-2767
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Fax |
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Provider Business Mailing Address
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Address Line | 12254 ROCKVILLE PIKE
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City | ROCKVILLE
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State | MD
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Zip | 20852-1608
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Country | US
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Telephone | 301-230-2767
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0102209670
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | H0104955
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License Number State | MD
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