Individual
DR. DANIEL DAE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
69149
WI
207WX0107X
Retina Specialist (Ophthalmology) Physician
69149
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001463478
AMERICAN ACADEMY OF OPHTHALMOLOGY
—
01
—
13928487
CAQH
—
05
—
163944904
—
WI
01
—
69149
WI STATE LICENSE
WI
Enumeration date
03/20/2012
Last updated
03/07/2023
Update your record
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