Provider Demographics
NPI:1992753354
Name:ANG, AN KING (MD)
Entity type:Individual
Prefix:DR
First Name:AN KING
Middle Name:
Last Name:ANG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 WILLIAM CARLS DR
Mailing Address - Street 2:REGIONAL SPECIALTY CENTER
Mailing Address - City:COMMERCE
Mailing Address - State:MI
Mailing Address - Zip Code:48382-2201
Mailing Address - Country:US
Mailing Address - Phone:248-937-3338
Mailing Address - Fax:248-937-5139
Practice Address - Street 1:1 WILLIAM CARLS DR
Practice Address - Street 2:REGIONAL SPECIALTY CENTER
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-2201
Practice Address - Country:US
Practice Address - Phone:248-937-3338
Practice Address - Fax:248-937-5139
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301047095208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI06309173021Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID
MIB46518Medicare UPIN