Provider Demographics
NPI:1427016989
Name:KUECK, ANGELA S (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:S
Last Name:KUECK
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Gender:F
Credentials:MD
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Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:LOBBY J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:TRINITY HEALTH IHA MEDICAL GROUP GYNECOLOGY ONCOLOGY
Practice Address - Street 2:5303 ELLIOT DRIVE SUITE 220
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-8632
Practice Address - Country:US
Practice Address - Phone:734-712-2005
Practice Address - Fax:734-712-2013
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-01-04
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Provider Licenses
StateLicense IDTaxonomies
CT049418207VX0201X
TXQ7907207VX0201X
MI4301081158207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1427016989Medicaid
TX357012902Medicaid
TX357012901Medicaid
CT1427016989Medicaid
TX357012901Medicaid