| Jiki Medical Associates, Llc | |
|
14804 Physicians Ln Suite 121 Rockville MD 20850-3941 | |
| (301) 610-6630 | |
| Not Available |
| Full Name | Jiki Medical Associates, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14804 Physicians Ln, Rockville, Maryland |
| Authorized Official Name and Position | Ji Yon Hwang-ki (DOCTOR) |
| Authorized Official Contact | 3016106630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jiki Medical Associates, Llc 14804 Physicians Ln Suite 121 Rockville MD 20850-3941 Ph: (301) 610-6630 | Jiki Medical Associates, Llc 14804 Physicians Ln Suite 121 Rockville MD 20850-3941 Ph: (301) 610-6630 |
| NPI Number | 1407043466 |
|---|---|
| Provider Enumeration Date | 10/03/2007 |
| Last Update Date | 12/07/2011 |
| Medicare PECOS PAC ID | 8527155118 |
|---|---|
| Medicare Enrollment ID | O20071029000680 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407043466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MDD 66159 (Maryland) | Primary |
| Provider Name | Ji Yon Hwang Ki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881899706 PECOS PAC ID: 9335236926 Enrollment ID: I20071029000691 |
| Provider Name | Mi Na Son |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801067707 PECOS PAC ID: 4981745072 Enrollment ID: I20100112000352 |
| Provider Name | Baekcheol Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114405537 PECOS PAC ID: 5193078905 Enrollment ID: I20181024002740 |
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