Provider Demographics
NPI:1881627941
Name:KANG-CHUN, KEUM DUK (MD)
Entity type:Individual
Prefix:DR
First Name:KEUM
Middle Name:DUK
Last Name:KANG-CHUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KEUM
Other - Middle Name:DUK
Other - Last Name:KANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2159 ANNS WAY
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9548
Mailing Address - Country:US
Mailing Address - Phone:734-482-5796
Mailing Address - Fax:
Practice Address - Street 1:8623 N WAYNE RD
Practice Address - Street 2:SUITE 323
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1137
Practice Address - Country:US
Practice Address - Phone:734-742-0605
Practice Address - Fax:734-742-0608
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010434352084P0800X, 2084P0802X, 2084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Not Answered2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE80253Medicare UPIN