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General NPI Number Information
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NPI Number | 1841004868
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Entity Type | Individual
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Provider Name | VIVLYN MATHIES KIMOU PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 2041 GEORGIA AVENUE, NW, 3RD FLOOR, SUITE 3200
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City | WASHINGTON
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State | DC
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Zip | 20060
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Country | US
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Telephone | 202-865-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 2041 GEORGIA AVENUE, NW, 3RD FLOOR, SUITE 3200
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City | WASHINGTON
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State | DC
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Zip | 20060
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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 | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | C0009806
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | C0009806
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | C0009806
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License Number State | MD
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