MEDICARE: DR. HAK-JOONG KIM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	20698	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306906664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAK-JOONG KIM M.D.

Provider Business Mailing Address
First Line	:	320 SHEFFIELD DR
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53005-7926
Country	:	US
Telephone Number	:	414-321-1900
Fax Number	:	414-321-0089

Provider Business Practice Location Address
First Line	:	5757 W OKLAHOMA AVE
Second Line	:	SUITE 101
City	:	MILWAUKEE
State	:	WI
Zip	:	53219-4303
Country	:	US
Telephone Number	:	414-321-1900
Fax Number	:	414-321-0089

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2006
Last Update Date	:	03/07/2023

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