Provider Demographics
NPI:1417377730
Name:KIL, DANIEL HYUN
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:HYUN
Last Name:KIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 WOODLEA MILL CT
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-2313
Mailing Address - Country:US
Mailing Address - Phone:703-304-4205
Mailing Address - Fax:
Practice Address - Street 1:1205 WOODLEA MILL CT
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-2313
Practice Address - Country:US
Practice Address - Phone:703-304-4205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-25
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10049465207R00000X
VA0101263692207R00000X
NY294140207R00000X
CAA150802207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine