Provider Demographics
NPI: | 1679654701 |
---|---|
Name: | KUHNS, LAWRENCE R (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | LAWRENCE |
Middle Name: | R |
Last Name: | KUHNS |
Suffix: | |
Gender: | M |
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: | 3621 S STATE ST |
Mailing Address - Street 2: | 700 KMS PLACE |
Mailing Address - City: | ANN ARBOR |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48108 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 734-936-2047 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1500 EAST MEDICAL CENTER DR |
Practice Address - Street 2: | 3RD FLOOR MOTT HOSPITAL RM F3313 |
Practice Address - City: | ANN ARBOR |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48109-0229 |
Practice Address - Country: | US |
Practice Address - Phone: | 734-936-7765 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-10-17 |
Last Update Date: | 2007-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MI | 4301028621 | 2085P0229X, 2085R0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Not Answered | 2085P0229X | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology |
Not Answered | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MI | 1219518 | Medicaid | |
MI | 1219518 | Medicaid |