Individual
KAO FENG MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2600 KILEY WAY, PLYMOUTH, WI 53073-5020
(920) 449-7000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7088-851
WI
246QM0706X
Medical Technologist
240959
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100088461
—
WI
Enumeration date
10/01/2012
Last updated
02/05/2024
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