Provider Demographics
NPI:1235108416
Name:KIM, HYUNBO HOLLY (MD)
Entity Type:Individual
Prefix:DR
First Name:HYUNBO
Middle Name:HOLLY
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:555 QUINCE ORCHARD RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1437
Mailing Address - Country:US
Mailing Address - Phone:301-926-3633
Mailing Address - Fax:301-948-9884
Practice Address - Street 1:555 QUINCE ORCHARD RD
Practice Address - Street 2:SUITE 350
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1437
Practice Address - Country:US
Practice Address - Phone:301-926-3633
Practice Address - Fax:301-948-9884
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0047453208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics