Provider Demographics
NPI:1619980901
Name:ZHONG, KUN (MD)
Entity Type:Individual
Prefix:
First Name:KUN
Middle Name:
Last Name:ZHONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21000 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336
Mailing Address - Country:US
Mailing Address - Phone:248-474-3132
Mailing Address - Fax:248-474-3181
Practice Address - Street 1:21000 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336
Practice Address - Country:US
Practice Address - Phone:248-474-3132
Practice Address - Fax:248-474-3181
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKZ063288207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3501644Medicaid
MI3501644Medicaid
G53494Medicare UPIN