Healthcare Provider Details

I. General information

NPI: 1134583685
Provider Name (Legal Business Name): HYUNYOUNG AHN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2016
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17400 W 13 MILE RD
BEVERLY HILLS MI
48025-5439
US

IV. Provider business mailing address

32964 BINGHAM LN
BINGHAM FARMS MI
48025-2418
US

V. Phone/Fax

Practice location:
  • Phone: 248-712-4120
  • Fax: 248-792-5243
Mailing address:
  • Phone: 248-990-8741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301508673
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: