Provider Demographics
NPI:1649221391
Name:STONER, KIMBERLY M (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:M
Last Name:STONER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:FROEDTERT & MEDICAL COLLEGE PRE-OP CLINIC
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6250
Mailing Address - Fax:414-805-7210
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:FROEDTERT & MEDICAL COLLEGE PRE-OP CLINIC
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6250
Practice Address - Fax:414-805-7210
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI475492084P0800X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34632500Medicaid
007806261WOtherHUMANA
WI1649221391Medicaid
0068R73601Medicare ID - Type Unspecified
WI34632500Medicaid