Healthcare Provider Details

I. General information

NPI: 1881627941
Provider Name (Legal Business Name): KEUM DUK KANG-CHUN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KEUM DUK KANG M.D.

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8623 N WAYNE RD SUITE 323
WESTLAND MI
48185-1137
US

IV. Provider business mailing address

2159 ANNS WAY
ANN ARBOR MI
48105-9548
US

V. Phone/Fax

Practice location:
  • Phone: 734-742-0605
  • Fax: 734-742-0608
Mailing address:
  • Phone: 734-482-5796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301043435
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number4301043435
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number4301043435
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: