MEDICARE: DR. YOOSANG TERRY KANG 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	207W00000X	Ophthalmology Physician	4301077128	MI

General Provider Information

NPI Number	:	1346380318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOOSANG TERRY KANG MD

Provider Business Mailing Address
First Line	:	308 S STATE ST
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48104-2412
Country	:	US
Telephone Number	:	734-622-8056
Fax Number	:

Provider Business Practice Location Address
First Line	:	308 S STATE ST
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48104-2412
Country	:	US
Telephone Number	:	734-622-8056
Fax Number	:

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	05/11/2023

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