Individual
SUNGGEUN SAMUEL IM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11199 31/2 MILE ROAD, BATTLE CREEK, MI 49015
(269) 979-2501
(269) 979-2501
Mailing address
11199 3 1/2 MILE RD, BATTLE CREEK, MI 49015-9370
(269) 979-2501
(269) 979-2501
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C55339
CA
208600000X
Surgery Physician
M-1695
GU
208D00000X
General Practice Physician
31469
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1077038
—
MI
Enumeration date
06/26/2006
Last updated
01/29/2013
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