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MICHAEL PARK M.D.

Allergy and Immunology

Portage, Michigan

Provider NPI: 1942204680

Provider Information:
 MICHAEL  PARK M.D.


Practice Location:
430 W CENTRE AVE  PORTAGE, MI 49024 US
Tel: 269-321-6673  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207K00000XPhysicians
Allergy & Immunology
MI4301063179

Other Provider Identifiers:

IssuerNumberStateType
4111376MI05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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