DR. THEODORE ALEXANDER KUNG (NPI# 1265695985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265695985 |
Entity Type | Individual |
Full Name | DR. THEODORE ALEXANDER KUNG |
Credential | MD |
Practice Address |
24 Frank Lloyd Wright Dr Lobby A Ann Arbor MI 48105-9484 |
Mailing Address |
3621 South State Street 700 Kms Place Ann Arbor MI 48108 |
Practice Telephone | 7349986022 |
Mailing Telephone | 7349362047 |
Enumeration Date | 2008-07-02 |
Last Update Date | 2016-08-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
4301092228 | MI | Allopathic & Osteopathic Physicians |
N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
MD60545604 | WA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | 1265695985 | 05 |
Street Address |
24 FRANK LLOYD WRIGHT DR LOBBY A |
City | ANN ARBOR |
State | MI |
Zip Code | 48105-9484 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174529127 | Paula Tuohy Miska | Nurse Practitioner | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48109 | 2005-06-23 |
1629540992 | Regents of The University of Michigan | Durable Medical Equipment & Medical Supplies | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-12-26 |
1477021160 | Lisa Jane Bosio | Registered Nurse | 24 Frank Lloyd Wright Dr, Lobby C Suite 1300, Ann Arbor, MI 48105-9484 | 2018-11-12 |
1770073199 | Regents of The University of Michigan | Dietitian, Registered | 24 Frank Lloyd Wright Dr, Dominos Farms Lobby C Suite 1300, Ann Arbor, MI 48106 | 2018-05-10 |
1861998411 | Dale Douglas Hazard | Physical Therapist | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-04-03 |
1144724303 | Kanisha Ward | Specialist/Technologist | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-22 |
1851894109 | Kristy Jo Bonasso | Occupational Therapist | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-13 |
1932602612 | Eric Kilpatrick | Specialist/Technologist | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-09 |
1679075659 | Kristen Hope Schuyten | Physical Therapist | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-06 |
1912409897 | Gary Kufel | Physical Medicine & Rehabilitation | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-06 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730728718 | Alexander Jendrusina | Psychologist | Va Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105 | 2019-12-23 |
1417515875 | Christine Shyh Wang | Student in an Organized Health Care Education/Training Program | 4029 Avenue Maria Drive, Lobby A, Suite 1200, Ann Arbor, MI 48105 | 2019-05-31 |
1013475003 | Ryan Wang | Physician Assistant | 4883 S. Ridgeside Cir, Ann Arbor, MI 48105 | 2019-03-08 |
1801366265 | Amruta Sonavaria | Physical Therapist | 4701 East Huron River Drive, Ann Arbor, MI 48105 | 2018-11-28 |
1568955730 | Alexander Sliwicki | Pediatrics | 1500 East Medical Drive, Medical Professional Building, Ann Arbor, MI 48105 | 2018-06-12 |
1902398464 | Austin Remington | Student in an Organized Health Care Education/Training Program | 4029 Ave Maria Drive, Lobby A, Suite 1200, Ann Arbor, MI 48105 | 2018-05-31 |
1881191658 | Stephen James Hickner | Student in an Organized Health Care Education/Training Program | St. Mary Mercy Outpatient Psychiatric Services, 2006 Hogback Road, Suite 1, Ann Arbor, MI 48105 | 2018-04-09 |
1245681709 | Winnie Nhan | Internal Medicine | 4000 Ave Maria Dr, Lobby C Suite 1300, Ann Arbor, MI 48105 | 2016-06-27 |
1861857971 | Connie Chen | Pharmacist | 2215 Fuller Road (119), Ann Arbor, MI 48105 | 2015-12-17 |
1407241193 | Stefan Craciun | Emergency Medicine | 3484 Ashburnam Rd, Ann Arbor, MI 48105 | 2015-03-31 |
Find all providers in zip 48105 |
Taxonomy Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851689525 | Robert Moore Oneal | Surgery | 501 Onondaga St, Ann Arbor, MI 48104-2606 | 2011-07-15 |
1457473605 | Ian Frazier Lytle | Surgery | 5333 Mcauley Drive, Suite 5001, Ann Arbor, MI 48106 | 2007-04-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629528765 | Paragon Health, P.C. | Surgery | 8175 Creekside Dr Ste 100, Portage, MI 49024-5370 | 2016-10-13 |
1487091989 | Trevor K O'brien | Surgery | 4110 Copper Ridge Dr Ste 242, Traverse City, MI 49684-6721 | 2013-05-24 |
1902072952 | Michigan Cosmetic & Reconstructive Surgery Pllc | Surgery | 29110 Inkster Rd, Ste 250, Southfield, MI 48034-1098 | 2008-04-30 |
1518184175 | Halil Ibrahim Canter | Surgery | 16001 West 9 Mile Rd., 3 Fl Fischer Ctr Providence Hosp. Craniofacial Inst., Southfield, MI 48075 | 2007-04-18 |
1285756148 | Andrea Emma Van Pelt | Surgery | 4070 Lake Drive Se, Suite 202, Grand Rapids, MI 49546 | 2007-04-04 |
1083741367 | Kenneth Wolf | Surgery | 1990 Union Lake Rd Ste 200, Commerce Township, MI 48382-2200 | 2007-02-27 |
1972630259 | Lauran Bryan | Surgery | 26711 Woodward Ave Ste Ll1, Huntington Woods, MI 48070-1370 | 2007-02-27 |
1689761439 | John J Iacobucci | Surgery | 221 Michigan St Ne Ste 300, Grand Rapids, MI 49503-2537 | 2006-10-05 |
1710996319 | Ewa D Komorowska-timek | Surgery | 3855 Burton St Se Ste A, Grand Rapids, MI 49546-5816 | 2006-08-05 |
1689689259 | Milena Diana Lambie | Surgery | 27750 Middlebelt Rd Ste 150, Farmington Hills, MI 48334-5007 | 2006-07-30 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.