Organization
SPINE AND SPORTS REGENERATIVE MEDICINE INSTITUTE
Active
Organization
SPINE AND SPORTS REGENERATIVE MEDICINE INSTITUTE
Active
Other names
Spine and Pain Regenerative Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID KIM MD (CEO)
(703) 349-4205
Entity
Organization
Contact information
Practice address
10721 MAIN ST STE 304, FAIRFAX, VA 22030-6902
(703) 349-4205
(703) 349-4205
Mailing address
10721 MAIN ST STE 304, FAIRFAX, VA 22030-6902
(703) 349-4205
(703) 349-4205
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
07/09/2024
Last updated
07/16/2024
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