Boonvisudhi, Kitima

Boonvisudhi, Kitima is an sole proprietor health care provider with primary practice located at 2901 W Kinnickinnic River Pkwy Ste 311, Milwaukee WI 53215-3677. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Boonvisudhi, Kitima can be contacted via phone (414) 385-8723.

Contact Information

Primary practice address
2901 W Kinnickinnic River Pkwy Ste 311 Milwaukee WI 53215-3677
Phone: (414) 385-8723
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 204411 New York
Allopathic & Osteopathic Physicians / Surgery 208600000X 59966 Wisconsin

Profile Details

NPI number 1134198005
LBN Legal business name Boonvisudhi, Kitima
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2006
Last updated Jan 30th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134198005 NPPES
New York MEDICAID 02440095

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