Provider Demographics
NPI:1346243805
Name:KIM, HIE C (MD)
Entity Type:Individual
Prefix:DR
First Name:HIE
Middle Name:C
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8925 BURKE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-1115
Mailing Address - Country:US
Mailing Address - Phone:703-978-9595
Mailing Address - Fax:703-978-2164
Practice Address - Street 1:8925 BURKE LAKE RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-1115
Practice Address - Country:US
Practice Address - Phone:703-978-9595
Practice Address - Fax:703-978-2164
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101023599174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA001961 AND 454203OtherANTHEM BCBS OF VA
VA27140OtherALLIANCE PPO
VA4371 0001OtherCAREFIRST BCBS
VA22463OtherUNICARE
VA250000292 C08088OtherMEDICARE VA
VA6861954Medicaid
VA0787066OtherAETNA HMO
VA2020511-SOtherCIGNA
VA4054650OtherAETNA US HEALTHCARE PPO
VA001961 AND 454203OtherTRIGON VA
VA6861954OtherMEDICAID VA HMO
VAD-43711253OtherCHAMPUS TRICARE
VAC-62323Medicare UPIN
VA4054650OtherAETNA US HEALTHCARE PPO