Eun-Jung P Kucway MD PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

EK074696 Issued in MI

Legal business name

EUN-JUNG P KUCWAY MD PLLC

Practice address

20755 Greenfield Rd
Suite 200
Southfield, MI 48075-5403

Phone

(248) 765-2892

NPI assigned

Sep 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Eun-Jung P Kuckway, M.D.

Title

Ceo/President

Phone

(248) 765-2892

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1376739664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4416",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480994416",
            "telephone_number": "248-765-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20755 GREENFIELD RD",
            "address_2": "SUITE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755403",
            "telephone_number": "248-765-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUN-JUNG P KUCWAY MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "KUCKWAY",
        "authorized_official_first_name": "EUN-JUNG",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "248-765-2892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "EK074696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE NUMBER",
            "identifier": "EK074696",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.