Provider Demographics
NPI:1760915102
Name:KIM, MICHAEL EUHYUN (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EUHYUN
Last Name:KIM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 N 92ND ST
Mailing Address - Street 2:SUITE 730
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4875
Mailing Address - Country:US
Mailing Address - Phone:414-266-6800
Mailing Address - Fax:414-337-7068
Practice Address - Street 1:999 N 92ND ST
Practice Address - Street 2:SUITE 730
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4875
Practice Address - Country:US
Practice Address - Phone:414-266-6800
Practice Address - Fax:414-337-7068
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program