Provider Demographics
NPI:1780682583
Name:KIM, ALBERT HO-SIEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:HO-SIEN
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3301 WOODBURN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-6890
Mailing Address - Country:US
Mailing Address - Phone:703-573-0800
Mailing Address - Fax:703-573-8809
Practice Address - Street 1:3301 WOODBURN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-6890
Practice Address - Country:US
Practice Address - Phone:703-573-0800
Practice Address - Fax:703-573-8809
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052912207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010090024Medicaid
VAH40744Medicare UPIN
DCG01562-C01Medicare PIN