Provider Demographics
NPI:1972540672
Name:LI, JUN (BM, PHD)
Entity type:Individual
Prefix:
First Name:JUN
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:BM, PHD
Other - Prefix:
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Mailing Address - Street 1:6560 FANNIN ST FL 8
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2761
Mailing Address - Country:US
Mailing Address - Phone:346-238-8221
Mailing Address - Fax:313-745-4216
Practice Address - Street 1:4201 SAINT ANTOINE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-745-4275
Practice Address - Fax:313-745-4216
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT69462084N0400X
MI53151716992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology