Provider Demographics
NPI:1386693166
Name:HUNG, CINDY K W (MD)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:K W
Last Name:HUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26185 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4709
Mailing Address - Country:US
Mailing Address - Phone:248-569-2040
Mailing Address - Fax:248-569-2048
Practice Address - Street 1:26185 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-4709
Practice Address - Country:US
Practice Address - Phone:248-569-2040
Practice Address - Fax:248-569-2048
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059337207Q00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4958821Medicaid
MI080D410020OtherBCBSM BCN COMM BLUE CHOIC
MI1022806OtherMHP HAN INDIVIDUAL
MI1022853OtherMHP HAN GROUP
MI4428146Medicaid
MI4428146Medicaid
MI4958821Medicaid
MIG09870Medicare UPIN