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NPI Code Detail

MEDICARE: DAVID KIM MD

MEDICARE: DAVID KIM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0014XInterventional Pain Medicine Physician0101234009VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1266870OTHERVAANTHEM

General Provider Information

NPI Number : 1073530523
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID KIM MD
Provider Business Mailing Address
First Line : 10721 MAIN ST STE 304
Second Line :
City : FAIRFAX
State : VA
Zip : 22030-6902
Country : US
Telephone Number : 37-349-4205
Fax Number : 703-740-3615
Provider Business Practice Location Address
First Line : 10721 MAIN ST STE 304
Second Line :
City : FAIRFAX
State : VA
Zip : 22030-6902
Country : US
Telephone Number : 703-349-4205
Fax Number : 703-349-4205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 11/07/2024

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Directions to “ DAVID KIM MD” Practice Location

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