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Joshua Kim, DO

Internal Medicine in Centreville, VA. Individual provider (NPI-1).

NPI number1679102792
StatusActive
Last updated in NPPESDec 3, 2024

Details

NPI
1679102792
Entity type
Individual (NPI-1)
Name
Joshua Kim
Credential
DO
Sex
Male
Sole proprietor
No
Enumeration date
Apr 2, 2020
Certification date
Dec 3, 2024
Last updated
Dec 3, 2024

Medicare and OIG

Medicare enrolled (PECOS)
Yes · PRACTITIONER - INTERNAL MEDICINE
Can order and refer
Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine0102208669VAYes
208000000X Pediatrics0102208669VA
208000000X Pediatrics51207R00000XMI
207R00000X Internal Medicine515151014352MI

Practice location

6208 Multiplex Dr Ste 150
Centreville, VA 20121-5324

Phone 571-833-7911 · Fax 571-833-7912

Mailing address

Po Box 748613
Atlanta, GA 30384-8613

Phone 434-295-1000

Other practice locations

25 Michigan St Ne Ste 2100
Grand Rapids, MI 49503-2526

Phone 616-391-3777

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine Physician providers in Centreville, VA

All 15 Internal Medicine Physician providers in Centreville · All 766 providers in Centreville

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