1386693166 NPI number — DR. CINDY K W HUNG M.D.

Table of content: DR. ROBERT MOUKARZEL M.D. (NPI 1285794693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386693166 NPI number — DR. CINDY K W HUNG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNG
Provider First Name:
CINDY
Provider Middle Name:
K W
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386693166
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26185 GREENFIELD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTHFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48076-4709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-569-2040
Provider Business Mailing Address Fax Number:
248-569-2048

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26185 GREENFIELD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTHFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48076-4709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-569-2040
Provider Business Practice Location Address Fax Number:
248-569-2048
Provider Enumeration Date:
05/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  4301059337 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RG0300X , with the licence number: 4301059337 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4958821 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 080D410020 . This is a "BCBSM BCN COMM BLUE CHOIC" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1022806 . This is a "MHP HAN INDIVIDUAL" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1022853 . This is a "MHP HAN GROUP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4428146 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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