Individual
CHUL WHA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10730 MAIN STREET, FAIRFAX, VA 22030
(301) 317-0020
(301) 317-0028
Mailing address
PO BOX 639, LAUREL, MD 20725-0639
(301) 317-0020
(301) 317-0028
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
BLUESHIELD
DC
05
—
000P60A41
—
TX
01
—
283901
ANTHEM
VA
05
—
5736315
—
VA
01
—
9105
BLUESHIELD
DC
05
—
G0034
—
TX
Enumeration date
10/25/2006
Last updated
07/09/2007
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