Individual
DR. JAE HONG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(248) 854-4576
Mailing address
1363 DOROTHEA RD, BERKLEY, MI 48072-2148
(248) 854-4576
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4351048809
MI
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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