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Individual
THEODORE KIM
Active
Individual
THEODORE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2014019005
MO
208M00000X
Hospitalist Physician
Primary
67171
WI
Other
Enumeration date
07/08/2014
Last updated
11/14/2022
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