Individual
JOHN ANDREW KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
325 E SILVER SPRING DR, WHITEFISH BAY, WI 53217-5222
(414) 247-4800
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
77475-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100216236
—
WI
Enumeration date
04/01/2021
Last updated
09/13/2024
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