Park, Tae Won
Park, Tae Won is an individual health care provider with primary practice located at 1547 S Wayne Rd , Westland MI 48186. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Park, Tae Won can be contacted via phone (734) 729-3133.Contact Information
Primary practice address
1547 S Wayne Rd
Westland MI 48186
Phone: (734) 729-3133
Fax: (734) 729-3130
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 4301035528 | Michigan |
Profile Details
| NPI number | 1538133020 |
|---|---|
| LBN Legal business name | Park, Tae Won |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Sep 28th, 2018 - about 7 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 | 1538133020 | NPPES |
| Michigan | MEDICAID | 109472710 |
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