Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 0101269151 | VA |
NPI | 1356795595 |
---|---|
Provider Name | Sharon Jee Yong Kim |
First Address | Fulton, MD 20759-2694 |
Second Address | Alexandria, VA 22310-3251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2016 |
Last Update Date | 13/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101269151 | MEDICAL LICENSE (01) | VA |