Individual
BYUNG GEUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
2501 W SILVER SPRING DR, GLENDALE, WI 53209-4217
(414) 461-9250
Mailing address
2501 W SILVER SPRING DR, GLENDALE, WI 53209-4217
(414) 461-9250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
163507
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163507
LICENSE
WI
Enumeration date
08/20/2014
Last updated
02/25/2016
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