Provider Demographics
NPI:1144514647
Name:KANG, HARLEEN (MD)
Entity type:Individual
Prefix:DR
First Name:HARLEEN
Middle Name:
Last Name:KANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:27450 SCHOENHERR RD
Mailing Address - Street 2:SUITE #500
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6683
Mailing Address - Country:US
Mailing Address - Phone:586-582-7632
Mailing Address - Fax:586-582-7633
Practice Address - Street 1:27450 SCHOENHERR RD
Practice Address - Street 2:SUITE #500
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6683
Practice Address - Country:US
Practice Address - Phone:586-582-7632
Practice Address - Fax:586-582-7633
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH57.016351207R00000X
OH35.120246208M00000X
MI4301108624207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0078398Medicaid