Im, Sunggeun Samuel

Im, Sunggeun Samuel is an individual health care provider with primary practice located at 11199 31/2 Mile Road , Battle Creek MI 49015. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Im, Sunggeun Samuel can be contacted via phone (269) 979-2501.

Contact Information

Primary practice address
11199 31/2 Mile Road Battle Creek MI 49015
Phone: (269) 979-2501
Fax: (269) 979-2501
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X M-1695 Guam
Allopathic & Osteopathic Physicians / Surgery 208600000X C55339 California
Allopathic & Osteopathic Physicians / General Practice 208D00000X 31469 Michigan

Profile Details

NPI number 1770510901
LBN Legal business name Im, Sunggeun Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Jan 29th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770510901 NPPES
Michigan MEDICAID 1077038

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