Organization
JAE KIM, MD PLC
Active
Other names
Jae Kim, MD Facial Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JAE KIM (AUTHORIZED MEMBER)
(347) 551-1113
Entity
Organization
Contact information
Practice address
10721 MAIN ST STE 205, FAIRFAX, VA 22030-6902
(703) 705-2100
(703) 935-0330
Mailing address
2200 WILSON BLVD STE 102-219, ARLINGTON, VA 22201-3397
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
04/01/2019
Last updated
06/11/2019
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