Individual
DR. THEODORE Y KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7350 VAN DUSEN RD, STE 210, LAUREL, MD 20707-5268
(301) 498-5500
(301) 498-7346
Mailing address
12510 PROSPERITY DR, STE 200, SILVER SPRING, MD 20904-1663
(240) 485-5200
(301) 625-6906
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
D0033979
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10040326
RAILROAD MEDICARE
MD
01
—
2516-0002
CAREFIRST BSDC
DC
05
—
275761300
—
MD
01
—
531224-01
CAREFIRST BSMD
MD
01
—
A1110003
CAREFIRST BCBS DC
DC
01
—
A1130004
CAREFIRST BCBS DC
DC
01
—
N5630029
CAREFIRST DC/MD
MD
01
—
P00679066
RAILROAD MEDICARE
MD
Enumeration date
06/20/2005
Last updated
07/08/2016
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