Individual provider Active NPI

Kun Kil Yu, MD

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1013920941
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301043091 Issued in MI
Practice address
19189 W 10 Mile Rd
Ste 200
Southfield, MI 48075-2453
Phone
(248) 948-7985
Fax
(248) 948-9031
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301043091 MI Primary

Addresses

Primary practice location

19189 W 10 Mile Rd
Ste 200
Southfield, MI 48075-2453

Mailing address

19189 W 10 Mile Rd
Ste 200
Southfield, MI 48075-2453
Phone (248) 948-7985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301043091MIMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1013920941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19189 W 10 MILE RD",
            "address_2": "STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752453",
            "telephone_number": "248-948-7985",
            "fax_number": "248-948-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19189 W 10 MILE RD",
            "address_2": "STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752453",
            "telephone_number": "248-948-7985",
            "fax_number": "248-948-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "KUN",
        "middle_name": "KIL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301043091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.