Individual
DR. MOON JA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
W231 N1440 CORPORATE CT, #310, WAUKESHA, WI 53186
(262) 896-6186
(262) 896-6139
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35449
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32463200
—
WI
Enumeration date
08/23/2006
Last updated
08/07/2024
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