MEDICARE: DR. KEUM DUK KANG-CHUN 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	2084P0800X	Psychiatry Physician	4301043435	MI
2	2084P0802X	Addiction Psychiatry Physician	4301043435	MI
3	2084F0202X	Forensic Psychiatry Physician	4301043435	MI

General Provider Information

NPI Number	:	1881627941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEUM DUK KANG-CHUN M.D.

Provider Business Mailing Address
First Line	:	2159 ANNS WAY
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48105-9548
Country	:	US
Telephone Number	:	734-482-5796
Fax Number	:

Provider Business Practice Location Address
First Line	:	8623 N WAYNE RD
Second Line	:	SUITE 323
City	:	WESTLAND
State	:	MI
Zip	:	48185-1137
Country	:	US
Telephone Number	:	734-742-0605
Fax Number	:	734-742-0608

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	09/11/2025

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