Individual
THEODORE TAE-HUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13135 ROUTE 50 STE 215, FAIRFAX, VA 22033-1907
(703) 378-5155
(703) 378-5166
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
0101239690
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982694618
—
VA
01
—
G02511A01
MEDICARE PTAN
DC
Enumeration date
10/25/2005
Last updated
01/26/2026
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