Mary E Kim, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D85905 Issued in MD

Practice address

10903 New Hampshire Ave # W022
Silver Spring, MD 20993-0002

Phone

(301) 796-2110

Fax

(301) 796-9895

NPI assigned

Apr 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Eun-Kyung Mary Kwon Other name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Dermatology

  Medicare reassignment NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1730523309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10903 NEW HAMPSHIRE AVE # W022",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209930002",
            "telephone_number": "301-796-2110",
            "fax_number": "301-796-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10903 NEW HAMPSHIRE AVE # W022",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209930002",
            "telephone_number": "301-796-2110",
            "fax_number": "301-796-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-25",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D85905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUN-KYUNG",
            "last_name": "KWON",
            "middle_name": "MARY",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Helen Jung-Hee Kim, CRNP
• Jean Kim, M.D.
• Jean He Kim, PHARMD
• Kyung Sik Kim, MD
• Lauren Kim, LCPC, LCPAT
• Robert Kim, DNP, FNP
• Sae-in Kim, M.D.
• Sara Bogeum Kim
• Shi Yoon Kim, PHARM. D
• Soohwan Kim, M.D.

• Dermatology Physician in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.