MEDICARE: DR. KENNETH KUEHN CHUN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	KC038189	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467511808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH KUEHN CHUN MD

Provider Business Mailing Address
First Line	:	43494 WOODWARD AVE
Second Line	:	SUITE 105
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5052
Country	:	US
Telephone Number	:	248-338-8220
Fax Number	:	248-338-0210

Provider Business Practice Location Address
First Line	:	43494 WOODWARD AVE
Second Line	:	SUITE 105
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5052
Country	:	US
Telephone Number	:	248-338-8220
Fax Number	:	248-338-0210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	11/21/2013

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