Provider Demographics
NPI:1649371014
Name:KANG, MI HWA (MD)
Entity type:Individual
Prefix:DR
First Name:MI
Middle Name:HWA
Last Name:KANG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3998 FAIR RIDGE DR
Mailing Address - Street 2:STE 300
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2921
Mailing Address - Country:US
Mailing Address - Phone:703-766-9737
Mailing Address - Fax:703-766-9725
Practice Address - Street 1:3600 JOSEPH SIEWICK DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1709
Practice Address - Country:US
Practice Address - Phone:703-391-3129
Practice Address - Fax:703-766-9725
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2015-03-16
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Provider Licenses
StateLicense IDTaxonomies
VA0101038929207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1047026OtherWORKER'S COMPENSATION
VA297594OtherAMERIGROUP
VA4526-8625OtherCARE FIRST
VAK142-0001OtherCARE FIRST 2005
VA484645OtherNCPPO
VA286296OtherANTHEM
VA050084074OtherRAILROAD MEDICARE
VA1649371014Medicaid
VA484645OtherNCPPO
VA4526-8625OtherCARE FIRST
VA1649371014Medicaid