Provider Demographics
NPI:1568967222
Name:KIM, GI YOON (MD)
Entity Type:Individual
Prefix:
First Name:GI YOON
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8800 W DOYNE AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1222
Mailing Address - Country:US
Mailing Address - Phone:414-805-5800
Mailing Address - Fax:414-805-8097
Practice Address - Street 1:8800 W DOYNE AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-1222
Practice Address - Country:US
Practice Address - Phone:414-805-5800
Practice Address - Fax:414-805-8097
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI81614208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1568967222Medicaid