Individual
JAEHAN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MICHIGAN ST NE # MC019, GRAND RAPIDS, MI 49503-2560
(616) 486-0310
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
Primary
4301511476
MI
2084N0400X
Neurology Physician
4301511476
MI
Other
Enumeration date
06/11/2018
Last updated
08/06/2024
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