Kim, Timothy Robert

Kim, Timothy Robert is an individual health care provider with primary practice located at N15W28300 Golf Rd , Pewaukee WI 53072-4800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Kim, Timothy Robert can be contacted via phone (262) 544-5311.

Contact Information

Primary practice address
N15W28300 Golf Rd Pewaukee WI 53072-4800
Fax: (262) 544-6820
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 33395-020 Wisconsin

Profile Details

NPI number 1760465231
LBN Legal business name Kim, Timothy Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2005
Last updated Nov 6th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760465231 NPPES
Other P00100373 RAIL ROAD MEDICARE
MEDICAID 1760465231 RAIL ROAD MEDICARE

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