Active NPI
Samba Jung, MD
- Internal Medicine Physician
- Waterford, MI
National Provider Identifier
1902907025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 032194
- Practice address
- 1724 Airport Rd
Waterford, MI 48327 - Phone
- (248) 674-1220
- Fax
- (248) 674-1398
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 032194 | MI | Primary |
Addresses
Primary practice location
1724 Airport Rd
Waterford, MI 48327
Mailing address
1724 Airport Rd
Waterford, MI 48327
Phone (248) 674-1220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1034335 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 032194 | MI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902907025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1724 AIRPORT RD",
"city": "WATERFORD",
"state": "MI",
"postal_code": "48327",
"telephone_number": "248-674-1220",
"fax_number": "248-674-1398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1724 AIRPORT RD",
"city": "WATERFORD",
"state": "MI",
"postal_code": "48327",
"telephone_number": "248-674-1220",
"fax_number": "248-674-1398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "SAMBA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "032194",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1034335",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.