| Peter D Kim Md Pc | |
|
4208 Evergreen Ln Suite 222 Annandale VA 22003-3235 | |
| (703) 642-2288 | |
| (703) 642-1224 |
| Full Name | Peter D Kim Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 4208 Evergreen Ln, Annandale, Virginia |
| Authorized Official Name and Position | Peter D Kim (PHYSICIAN) |
| Authorized Official Contact | 7036422288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter D Kim Md Pc 4208 Evergreen Ln Suite 222 Annandale VA 22003-3235 Ph: (703) 642-2288 | Peter D Kim Md Pc 4208 Evergreen Ln Suite 222 Annandale VA 22003-3235 Ph: (703) 642-2288 |
| NPI Number | 1134309685 |
|---|---|
| Provider Enumeration Date | 11/13/2007 |
| Last Update Date | 01/16/2014 |
| Medicare PECOS PAC ID | 8729000757 |
|---|---|
| Medicare Enrollment ID | O20051219000801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134309685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Peter Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417925900 PECOS PAC ID: 9537139522 Enrollment ID: I20051219000844 |
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