THOMAS T PARK (NPI# 1629169412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629169412 |
Entity Type | Individual |
Full Name | THOMAS T PARK |
Credential | M.D |
Practice Address |
4160 John R St 916 Detroit MI 48201-2020 |
Practice Telephone | 3138320011 |
Practice Fax Number | 3138327609 |
Mailing Telephone | 3138320011 |
Mailing Fax Number | 3138327609 |
Enumeration Date | 2006-09-27 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
040933 | MI | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063619419 | Thomas Park | Dentist | 134 New Haven Rd, Seymour, CT 06483-3908 | 2007-06-29 |
1619359288 | Thomas Park | Internal Medicine | 1600 Sw Archer Rd # 100277, Gainesville, FL 32610 | 2015-06-19 |
1790055358 | Thomas Park | Counselor | 627 Ne Evans St, Mcminnville, OR 97128-3923 | 2012-01-12 |
1669756045 | Thomas Park | Pharmacist | 1260 Liberty Rd, Eldersburg, MD 21784-7928 | 2011-10-04 |
1174843163 | Thomas Park | Psychiatry & Neurology | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2010-06-02 |
1609976547 | Thomas Chin Park | Surgery | 2725 Capitol Ave, Suite 402, Sacramento, CA 95816-6004 | 2006-09-22 |
1609835198 | Thomas Park | Internal Medicine | 601 Elmwood Ave, Box 646, Rochester, NY 14642-0001 | 2006-03-22 |
1194707562 | Thomas S Park | Pharmacist | 23357 Pacific Coast Hwy, Malibu, CA 90265-4957 | 2005-11-18 |
1952304792 | Thomas M Park | Orthopaedic Surgery | 3334 Capital Medical Blvd, Ste. 400, Tallahassee, FL 32308-8405 | 2005-05-24 |
Street Address |
4160 JOHN R ST 916 |
City | DETROIT |
State | MI |
Zip Code | 48201-2020 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508864240 | Uma D Gorrepati | Internal Medicine | 4160 John R St, Suite 730, Detroit, MI 48201-2020 | 2005-07-07 |
1306466826 | Joseph Trak | Student in an Organized Health Care Education/Training Program | 4160 John R St, Suite 615, Detroit, MI 48201 | 2020-04-24 |
1437717097 | Fauzia Zubair Arain | Student in an Organized Health Care Education/Training Program | 4160 John R St, Detroit, MI 48201-2020 | 2019-05-30 |
1821520495 | Yang Liu | Student in an Organized Health Care Education/Training Program | 4160 John R St, Suite 615, Detroit, MI 48201-2020 | 2017-04-01 |
1053859256 | Karin Calviti | Audiologist | 4160 John R St, Detroit, MI 48201-2020 | 2017-02-07 |
1932551348 | Ayman Abulawi | Student in an Organized Health Care Education/Training Program | 4160 John R St, Suite 510, Detroit, MI 48201-2020 | 2016-07-09 |
1407204027 | Amir Laktineh | Student in an Organized Health Care Education/Training Program | 4160 John R St, 510, Detroit, MI 48201-2020 | 2016-05-25 |
1801243548 | Mohannad Alhasani | Internal Medicine | 4160 John R St, Suite 510, Detroit, MI 48201-2020 | 2016-05-23 |
1073976353 | Catherine Peterson | Student in an Organized Health Care Education/Training Program | 4160 John R St, Suite 930, Detroit, MI 48201-2020 | 2016-04-03 |
1598128902 | Aubrey Brian Allen | Student in an Organized Health Care Education/Training Program | 4160 John R St, 1021, Detroit, MI 48201-2020 | 2016-04-01 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
Find all providers in zip 48201 |
Taxonomy Code | 2084A0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Addiction Medicine |
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780692590 | Vijayalakshmi A Kololgi | Psychiatry & Neurology | 4646 John R St, Detroit, MI 48201 | 2006-08-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740821339 | Farrah Laviolette | Psychiatry & Neurology | 9178 Highland Rd Ste A, White Lake, MI 48386-4619 | 2019-10-04 |
1427563089 | Mlrc A Medical Group PC | Psychiatry & Neurology | 26803 Ryan Rd, Warren, MI 48091-4075 | 2017-12-05 |
1528180841 | Michael Notorangelo | Psychiatry & Neurology | 229 E 3rd St, Harbor Springs, MI 49740 | 2007-04-06 |
1629120282 | Sanjeev Shanmuga Venkataraman | Psychiatry & Neurology | 4111 Andover Rd, Suite 220, Bloomfield Hills, MI 48302-1909 | 2007-01-16 |
1538190541 | Sunil Ramchand Rangwani | Psychiatry & Neurology | 317 E Warwick Dr, Suite B, Alma, MI 48801-1085 | 2006-07-06 |
1376500090 | Michael Fulton Brooks | Psychiatry & Neurology | 12851 East Grand River, Brighton Hospital, Brighton, MI 48116 | 2006-04-27 |
1508154626 | Lewei Lin | Psychiatry & Neurology | 4250 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2011-07-11 |
1689907966 | Center for Behavioral Medicine Pllc | Psychiatry & Neurology | 700 S Main St, Suite 210, Lapeer, MI 48446-3077 | 2009-09-17 |
1174771083 | Alan Robert Teo | Psychiatry & Neurology | 4250 Plymouth Rd, Ann Arbor, MI 48109-2700 | 2008-09-04 |
1437318771 | Avinash Hosanagar | Psychiatry & Neurology | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2008-06-02 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.