Healthcare Provider Details

I. General information

NPI: 1639146434
Provider Name (Legal Business Name): CHUNG-MING HEUNG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 S MAIN ST
CHELSEA MI
48118-1434
US

IV. Provider business mailing address

2100 COMMONWEALTH BLVD SUITE 202
ANN ARBOR MI
48105-1593
US

V. Phone/Fax

Practice location:
  • Phone: 734-475-9175
  • Fax: 734-475-0120
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301081311
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: