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General NPI Number Information
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NPI Number | 1700537750
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Entity Type | Individual
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Provider Name | HYEON IM
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Gender | Male
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 03/29/2025
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Provider Practice Location Address
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Address Line | 5004 FRAN PL APT 302
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City | LINCOLNIA
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State | VA
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Zip | 22312-5086
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Country | US
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Telephone | 202-815-8084
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Fax |
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Provider Business Mailing Address
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Address Line | 1890 PRESTON WHITE DR STE 265
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City | RESTON
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State | VA
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Zip | 20191-5471
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Country | US
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Telephone | 703-520-9980
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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