Whalio Doctors

NPI 1336375450

Su Min Ko, MD

Practitioner Interventional Pain Medicine Physician Fairfax, VA

Practice location

Address
11166 Fairfax Blvd Suite 105, Fairfax, VA 22030-5017
Phone
(703) 277-3360
Fax
(703) 277-3370

Registered specialties (4)

Interventional Pain Medicine Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 208VP0014X Licence 0101250991 (VA)
Physical Medicine & Rehabilitation Physician
Allopathic & Osteopathic Physicians Taxonomy 208100000X Licence 2009001606 (MO)
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Allopathic & Osteopathic Physicians Taxonomy 2081P2900X Licence 2009001606 (MO)
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Allopathic & Osteopathic Physicians Taxonomy 2081P2900X Licence 0101250991 (VA)

Registry record

NPI
1336375450
Entity type
Individual
Sex (as registered)
Male
NPI issued
3 Jun 2009
Record last updated
20 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.