Individual
ALICE JEANNE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-5000
Mailing address
3975 MAY CENTER RD, LAKE ORION, MI 48360-2513
(248) 961-3557
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301096950
MI
207Q00000X
Family Medicine Physician
Primary
MD210848
OR
Other
Enumeration date
06/30/2010
Last updated
06/20/2022
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