THEODORE TAE-HUN KIM M.D.
Allergy and Immunology
Chantilly, Virginia
Provider NPI: 1982694618
Provider Information:THEODORE TAE-HUN KIM M.D.
Practice Location:
4229 LAFAYETTE CENTER DR UNIT 1760 CHANTILLY, VA 20151 US
Tel: 703-378-5155 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207K00000X | Physicians Allergy & Immunology | VA | 0101239690 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| ANTHEM | 293910 | VA | 01 |
| AETNA | 7190863 | VA | 01 |
| MEDICARE PTAN | G02511A01 | DC | 01 |
| AETNA | 1660925 | VA | 01 |
| 010326338 | VA | 05 | |
| UNITED HEALTH CARE | 5162897 | VA | 01 |
| NCPPO | 774606 | VA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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