Organization
MARYLAND EYE PHYSICIAN AND SURGEON, LLC
Active
Other names
Maryland Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALISA KIM M.D. (MEDICAL DIRECTOR)
(240) 671-3808
Entity
Organization
Contact information
Practice address
2403 RESEARCH BLVD STE 102, SUITE 102, ROCKVILLE, MD 20850-6233
(240) 671-3808
(240) 232-2016
Mailing address
11217 KORMAN DR, POTOMAC, MD 20854-2049
(240) 671-3808
(240) 232-2016
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D0061666
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
331604100
—
MD
05
—
405809700
—
MD
Enumeration date
01/02/2012
Last updated
12/01/2023
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