Individual
DR. CHAN S. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MICHUMI, PLLC DBA MED EXPRESS OF WILLIAMSBURG, VA, 120 MONTICELLO AVE, WILLIAMSBURG, VA 23185
(757) 564-3627
(757) 564-6449
Mailing address
PO BOX 5508, VIRGINIA BEACH, VA 23471-0508
(757) 340-3489
(757) 340-4278
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101043881
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010094321
—
VA
01
—
P00153223
RRMED
VA
Enumeration date
02/09/2006
Last updated
08/07/2008
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