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General NPI Number Information
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NPI Number | 1750613089
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Entity Type | Organization
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Legal Business Name | HAK-JOONG KIM M.D. S.C.
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 02/11/2010
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Provider Practice Location Address
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Address Line | 5757 W OKLAHOMA AVE SUITE 101
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City | MILWAUKEE
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State | WI
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Zip | 53219-4303
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Country | US
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Telephone | 414-321-1900
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Fax | 414-321-0089
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Provider Business Mailing Address
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Address Line | 320 SHEFFIELD DR
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City | BROOKFIELD
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State | WI
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Zip | 53005-7926
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Country | US
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Telephone | 414-321-1900
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Fax | 414-321-0089
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HAK-JOONG KIM
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Credential | M.D.
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Telephone | 414-321-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 20698-30
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License Number State | WI
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