Individual
JIKERKHOUN SIMOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3300
(703) 776-4001
(703) 776-7113
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101255104
VA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
0101255104
VA
207RI0200X
Infectious Disease Physician
0101255104
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101255104
VA LICENSE
VA
Enumeration date
08/19/2006
Last updated
04/15/2022
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