Park, Michael
Park, Michael is an sole proprietor health care provider with primary practice located at 430 W Centre Ave , Portage MI 49024-5304. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Park, Michael can be contacted via phone (269) 321-6673.Contact Information
Primary practice address
430 W Centre Ave
Portage MI 49024-5304
Phone: (269) 321-6673
Fax: (269) 324-5594
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 4301063179 | Michigan |
Profile Details
| NPI number | 1942204680 |
|---|---|
| LBN Legal business name | Park, Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 10th, 2005 |
| Last updated | Jul 16th, 2007 - about 19 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942204680 | NPPES |
| Michigan | MEDICAID | 4111376 |
Popular Providers
-
Hoffman, Leonard S.
902 Frostwood Dr 302, Houston TX 77024-2420 -
Holman, Todd Read
1009 N 4Th St Ste A, Longview TX 75601-4768 -
Rodriguez, Gilberto E
470 Sentry Pkwy E Ste 200, Blue Bell PA 19422-2324 -
Del Mundo, Judy T
2061 Clarmar Way Ste A, San Jose CA 95128-1706 -
Fogg, Matthew I
470 Sentry Pkwy E Ste 200, Blue Bell PA 19422-2324 -
Spiegel, William
470 Sentry Pkwy E Ste 200, Blue Bell PA 19422-2324 -
Hurtado, Rodrigo C
3450 N Beauregard St Ste 1, Alexandria VA 22302-1200 -
Rodriguez, Ray Jaime
7730 Old Canton Rd Bldg B , Madison MS 39110-9299