# PETER D KIM MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134309685
- **Authorized official:** PETER D KIM M.D. (PHYSICIAN)
- **Authorized official phone:** (703) 642-2288

## Contact information

- **Practice address:** 4208 EVERGREEN LN, SUITE 222, ANNANDALE, VA 22003-3235
- **Practice address phone:** (703) 642-2288
- **Practice address fax:** (703) 642-1224
- **Mailing address:** 4208 EVERGREEN LN, SUITE 222, ANNANDALE, VA 22003-3235
- **Mailing address phone:** (703) 642-2288
- **Mailing address fax:** (703) 642-1224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/13/2007
- **Last updated:** 01/16/2014