Provider Demographics
NPI:1346331279
Name:LEUNG, FOOK NING (MD)
Entity Type:Individual
Prefix:DR
First Name:FOOK
Middle Name:NING
Last Name:LEUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 STRICKLAND DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2552
Mailing Address - Country:US
Mailing Address - Phone:313-369-1717
Mailing Address - Fax:313-369-1728
Practice Address - Street 1:17141 RYAN RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48212-1112
Practice Address - Country:US
Practice Address - Phone:313-369-1717
Practice Address - Fax:313-369-1728
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010340662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4662185Medicaid
MIOH26282028Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
MI4662185Medicaid