Individual
DR. TIMOTHY ROBERT KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 544-5311
(262) 544-6820
Mailing address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 303-5000
(262) 303-5006
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
33395-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760465231
—
WI
01
—
P00100373
RAIL ROAD MEDICARE
—
Enumeration date
11/29/2005
Last updated
11/06/2019
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