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:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1770510901 | NPPES |
Michigan | MEDICAID | 1077038 |
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