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General NPI Number Information
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NPI Number | 1588395925
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Entity Type | Individual
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Provider Name | JOHN RUNGE MD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 1500 E MEDICAL CENTER DR FL 1
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City | ANN ARBOR
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State | MI
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Zip | 48109-5000
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Country | US
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Telephone | 734-936-4054
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 E MEDICAL CENTER DR FL 1
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City | ANN ARBOR
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State | MI
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Zip | 48109-5000
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Country | US
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Telephone | 734-936-4054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | LL88227
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LL88227
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 4351050471
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License Number State | MI
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