Individual
SOO AH KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
14555 W NATIONAL AVE, SUITE 165, NEW BERLIN, WI 53151-4494
(262) 827-7074
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
62849
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100040054
—
WI
Enumeration date
06/29/2009
Last updated
12/08/2023
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