Individual
JOUNG HO PARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25710 KELLY RD, STE 3, ROSEVILLE, MI 48066
(586) 772-2600
(586) 772-5289
Mailing address
25710 KELLY RD, STE 3, ROSEVILLE, MI 48066
(586) 772-2600
(586) 772-5289
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
034719
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1390410
—
MI
Enumeration date
05/08/2006
Last updated
07/08/2007
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