William Kyungha Joh

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301032373 Issued in MI

Practice address

3028 W Grand Blvd
Detroit, MI 48202-6028

Phone

(313) 456-1553

Fax

(313) 456-1579

NPI assigned

Apr 16, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kyungha Joe Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271376000000",
    "number": "1972829893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 PEMBROOKE XING",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483221794",
            "telephone_number": "248-505-1783",
            "fax_number": "313-456-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3028 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482026028",
            "telephone_number": "313-456-1553",
            "fax_number": "313-456-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOH",
        "first_name": "WILLIAM",
        "middle_name": "KYUNGHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-16",
        "last_updated": "2010-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301032373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYUNGHA",
            "last_name": "JOE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rosemary Job
• Kasey Terese Jodway, RN
• Stephen J Joe, MD
• Joe'S Medical Supplies, L.L.C.
• Carmen Jackson Joel, BACHLEOR OF ARTS
• Johanna J Verwilghen MD PLLC
• Lynne C. Johannessen, M.D.
• Emma Kate Johanon, MBA, RDN
• John D Dingell VA Medical Center
• John D Dingell VA Medical Center

• All providers in Detroit, MI
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; 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.