Boonvisudhi, Kitima
Boonvisudhi, Kitima is an sole proprietor health care provider with primary practice located at 2901 W Kinnickinnic River Pkwy Ste 311, Milwaukee WI 53215-3677. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Boonvisudhi, Kitima can be contacted via phone (414) 385-8723.Contact Information
Primary practice address
2901 W Kinnickinnic River Pkwy Ste 311
Milwaukee WI 53215-3677
Phone: (414) 385-8723
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 204411 | New York |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 59966 | Wisconsin |
Profile Details
| NPI number | 1134198005 |
|---|---|
| LBN Legal business name | Boonvisudhi, Kitima |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Jan 30th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134198005 | NPPES |
| New York | MEDICAID | 02440095 |
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