Provider Demographics
NPI:1063662633
Name:SHIMY, KIM JAIN (MD)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:JAIN
Last Name:SHIMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:JAIN
Other - Last Name:SHAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:111 MICHIGAN AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2916
Mailing Address - Country:US
Mailing Address - Phone:202-476-2121
Mailing Address - Fax:202-476-4095
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-2121
Practice Address - Fax:202-476-4095
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0440222080P0205X
MDD00812292080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology