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Individual

PIERCE C. PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1414 W FAIR AVE, SUITE 344, MARQUETTE, MI 49855-2675
(906) 225-3910
(906) 225-4529
Mailing address
1414 W FAIR AVE, SUITE 344, MARQUETTE, MI 49855-2675
(906) 225-3910
(906) 225-4529

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
35-092802
OH
207RN0300X
Nephrology Physician
Primary
4301103759
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2949153
OH
Enumeration date
01/23/2007
Last updated
06/26/2013
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