Boo Keun Kim, MD, PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

D13621 Issued in MD

Legal business name

BOO KEUN KIM, MD, PA

Practice address

8921 Shady Grove Court
Gaithersburg, MD 20877-1308

Phone

(301) 840-8545

Fax

(301) 840-8520

NPI assigned

Oct 4, 2010

Organization subpart

Yes

Parent organization

BOO KEUN KIM, MD, PAAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Boo Keun Kim, M.D.

Title

Physician

Phone

(301) 840-8545

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Boo Keun Kim MD PA

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286150400000",
    "number": "1134438575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 SHADY GROVE COURT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771308",
            "telephone_number": "301-840-8545",
            "fax_number": "301-840-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8921 SHADY GROVE COURT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771308",
            "telephone_number": "301-840-8545",
            "fax_number": "301-840-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOO KEUN KIM, MD, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOO KEUN KIM, MD, PA",
        "enumeration_date": "2010-10-04",
        "last_updated": "2010-10-04",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "BOO",
        "authorized_official_middle_name": "KEUN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "301-840-8545",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D13621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006091700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Gastroenterology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.