MEDICARE: JAMES HSU M.D.

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	207P00000X	Emergency Medicine Physician	4301046380	MI

General Provider Information

NPI Number	:	1407016652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES HSU M.D.

Provider Business Mailing Address
First Line	:	5762 GALVIN RD
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7966
Country	:	US
Telephone Number	:	231-943-8032
Fax Number	:

Provider Business Practice Location Address
First Line	:	5762 GALVIN RD
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7966
Country	:	US
Telephone Number	:	231-943-8032
Fax Number	:

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

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	06/11/2008

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