Kim, Alisa

Kim, Alisa is an individual health care provider with primary practice located at 2403 Research Blvd Ste 102 Suite 102, Rockville MD 20850-6233. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Kim, Alisa can be contacted via phone (240) 232-2020.

Contact Information

Primary practice address
2403 Research Blvd Ste 102 Suite 102 Rockville MD 20850-6233
Phone: (240) 232-2020
Fax: (240) 232-2016
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X D61666 Maryland

Profile Details

NPI number 1114968336
LBN Legal business name Kim, Alisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Dec 1st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114968336 NPPES
Maryland Other 243875 MEDICARE PTAN
Maryland MEDICAID 405809700 MEDICARE PTAN
Maryland Other 178540YGP3 MEDICARE PTAN
Maryland Other 243873 MEDICARE PTAN

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