| Shukung Pllc | |
|
107 N Greenfield Rd Ste 1 Mesa AZ 85205-7802 | |
| (480) 741-8041 | |
| (480) 741-8045 |
| Full Name | Shukung Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 107 N Greenfield Rd Ste 1, Mesa, Arizona |
| Authorized Official Name and Position | Shu Ting Kung (PHYSICIAN) |
| Authorized Official Contact | 4807418041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shukung Pllc 107 N Greenfield Rd Ste 1 Mesa AZ 85205-7802 Ph: (480) 741-8041 | Shukung Pllc 107 N Greenfield Rd Ste 1 Mesa AZ 85205-7802 Ph: (480) 741-8041 |
| NPI Number | 1649968645 |
|---|---|
| Provider Enumeration Date | 04/27/2023 |
| Last Update Date | 09/26/2024 |
| Medicare PECOS PAC ID | 8224483961 |
|---|---|
| Medicare Enrollment ID | O20231016001743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649968645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shu Ting Kung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053706705 PECOS PAC ID: 1355654567 Enrollment ID: I20180611002971 |
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