Misuk Kim MD OBGYN PLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

0101244491 Issued in VA

Legal business name

MISUK KIM MD OBGYN PLC

Practice address

4304 Evergreen LN
Ste 104
Annandale, VA 22003-3216

Phone

(703) 658-8282

Fax

(703) 658-8283

NPI assigned

Sep 21, 2009

Organization subpart

No

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

Authorized official

Name

Mi Suk Kim, MDNPI 1508017716

Title

Sole Member

Phone

(703) 658-8282

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Misuk Agnes Kim, M.D.

  • Obstetrics & Gynecology Physician
  • Annandale, VA
  • NPI 1508017716

  DC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253491200000",
    "number": "1487988648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4304 EVERGREEN LN",
            "address_2": "STE 104",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033216",
            "telephone_number": "703-658-8282",
            "fax_number": "703-658-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 EVERGREEN LN",
            "address_2": "STE 104",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033216",
            "telephone_number": "703-658-8282",
            "fax_number": "703-658-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISUK KIM MD OBGYN PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-09-21",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MI SUK",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "703-658-8282",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101244491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mirza S Baig MD PC
• Christopher Neal Mishik, LPC
• Becky M Mohning, MS, RD, LD
• Monica Hayward
• Julie A Montgomery, MA, NCC, LPC
• Judith Montville-White, LCSW
• Kyung Wook Moon, D.C.

• Obstetrics & Gynecology Physician in Annandale, VA
• Providers in Annandale, VA by specialty
• Obstetrics & Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.