Individual
MICHAEL PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 MEMORIAL DR, SUITE 3950, PINEHURST, NC 28374-8707
(910) 295-4400
Mailing address
30 MEMORIAL DR, SUITE 3950, PINEHURST, NC 28374-8707
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
103478
NC
Other
Enumeration date
06/05/2006
Last updated
05/24/2021
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