Provider Demographics
NPI:1124004023
Name:KIM, ANDREW CHUL-WOOK (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CHUL-WOOK
Last Name:KIM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8618 SUNBEAM PL
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-5756
Mailing Address - Country:US
Mailing Address - Phone:410-792-2550
Mailing Address - Fax:
Practice Address - Street 1:8725 JOHN J KINGMAN RD
Practice Address - Street 2:DTRA, STOP 6201
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-6217
Practice Address - Country:US
Practice Address - Phone:703-767-4997
Practice Address - Fax:703-767-4999
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0006489207R00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine