Kelly Chung Walsh, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301090441 Issued in MI

Practice address

3601 W. 13 Mile Rd
Royal Oak, MI 48073-6769

Phone

(248) 898-7999

Fax

(248) 423-2576

NPI assigned

May 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kelly Chung Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1235186503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W. 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736769",
            "telephone_number": "248-898-7999",
            "fax_number": "248-423-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W. 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736769",
            "telephone_number": "248-898-7999",
            "fax_number": "248-423-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KELLY",
        "middle_name": "CHUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301090441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CHUNG",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalie Wallace, OTR/L
• Colleen Elizabeth Walling, PA-C
• Hannah Elisabeth Walmsley-Solt, CRNA
• Tina Walny
• Christopher Walsh
• Max T Walsh, MD
• Rachel Walsh, LMSW
• Sydney A Walsh, PH.D.
• Adam Paul Walters
• Bradford Walters, M.D.

• Internal Medicine Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.