Active NPI
Voravut Rungpradubvong, M.D.
- Legal Medicine
- Ann Arbor, MI
National Provider Identifier
1861808594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- 4301105724
- Practice address
- 1111 Maiden Lane CT Apt 106
Ann Arbor, MI 48105-1927 - Phone
- (734) 272-7500
- NPI assigned
- Jul 2, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | 4301105724 | MI | Primary |
Addresses
Primary practice location
1111 Maiden Lane CT Apt 106
Ann Arbor, MI 48105-1927
Mailing address
1111 Maiden Lane CT Apt 106
Ann Arbor, MI 48105-1927
Phone (734) 272-7500
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301105724 | MI | MD | Legal Medicine |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404259200000",
"number": "1861808594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 MAIDEN LANE CT APT 106",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481051927",
"telephone_number": "734-272-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 MAIDEN LANE CT APT 106",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481051927",
"telephone_number": "734-272-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNGPRADUBVONG",
"first_name": "VORAVUT",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-02",
"last_updated": "2014-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "MI",
"license": "4301105724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.