Individual
EDWIN H. KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8629 SUDLEY RD, SUITE 102, MANASSAS, VA 20110-4590
(703) 361-3030
(703) 361-2687
Mailing address
8629 SUDLEY RD, SUITE 102, MANASSAS, VA 20110-4590
(703) 361-3030
(703) 361-2687
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101226427
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10029139
—
VA
05
—
10038294
—
VA
05
—
10038316
—
VA
05
—
10038341
—
VA
05
—
10038383
—
VA
01
—
6688-0027
CAREFIRST
VA
Enumeration date
01/23/2006
Last updated
08/09/2011
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