Individual
WALTER J KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13250 WASHINGTON AVE, MOUNT PLEASANT, WI 53177-1516
(888) 720-2012
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
69704
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080577
—
WI
Enumeration date
04/10/2012
Last updated
08/19/2024
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