Individual
DR. HEEDONG PARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9463 HOLLY RD, SUITE 102, GRAND BLANC, MI 48439-8351
(810) 579-2600
(810) 579-2601
Mailing address
9463 HOLLY RD, SUITE 102, GRAND BLANC, MI 48439-8351
(810) 579-2600
(810) 579-2601
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
HP031219
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1158145
—
MI
Enumeration date
04/03/2006
Last updated
07/09/2007
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