Individual
DR. THOMAS PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23077 GREENFIELD #430, SOUTHFIELD, MI 48075
(248) 552-0044
(248) 423-7777
Mailing address
23077 GREENFIELD #430, SOUTHFIELD, MI 48075
(248) 552-0044
(248) 423-7777
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
040933
MI
2084P0800X
Psychiatry Physician
Primary
4301040933
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M13298001
PTAN
MI
Enumeration date
09/27/2006
Last updated
08/16/2023
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