Bae, Kyoung Soo

Bae, Kyoung Soo is an individual health care provider with primary practice located at 36175 Harper Ave , Clinton Township MI 48035-3274. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Bae, Kyoung Soo can be contacted via phone (586) 741-3772.

Contact Information

Primary practice address
36175 Harper Ave Clinton Township MI 48035-3274
Phone: (586) 741-3772
Fax: (586) 741-4604
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 4301031350 Michigan

Profile Details

NPI number 1033114848
LBN Legal business name Bae, Kyoung Soo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Sep 29th, 2026 - about 2 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033114848 NPPES
Michigan Other 0H26188 BCBS PROVIDER NUMBER
Michigan Other 0Q26008 BCBS PROVIDER NUMBER
Michigan Other 110922 BCBS PROVIDER NUMBER
Michigan Other 1006439 BCBS PROVIDER NUMBER
Michigan MEDICAID 3558987 BCBS PROVIDER NUMBER

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