DR. SUNGNAN PARK-DAVIS (NPI# 1932291432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932291432 |
| Entity Type | Individual |
| Full Name | DR. SUNGNAN PARK-DAVIS |
| Credential | MD |
| Practice Address |
30880 Beck Rd Novi MI 48377-1000 |
| Practice Telephone | 2489260009 |
| Practice Fax Number | 2489569198 |
| Mailing Telephone | 2489260009 |
| Mailing Fax Number | 2489569198 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2019-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0000X |
Internal Medicine Specialization: Adolescent Medicine |
4301076848 | MI | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 4301076848 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4675192 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2300 Haggerty Rd Ste 2140, West Bloomfield, MI 483232191 | 2486695050 | 2486691700 |
| Street Address |
30880 BECK RD |
| City | NOVI |
| State | MI |
| Zip Code | 48377-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255329173 | Deborah Raye Bennett | Family Medicine | 30880 Beck Rd, Novi, MI 48377 | 2005-10-13 |
| 1346885910 | Merissa May Garmo | Physician Assistant | 30880 Beck Rd, Novi, MI 48377-1000 | 2019-11-07 |
| 1700396868 | Farrah Thwainey | Dietitian, Registered | 30880 Beck Rd, Novi, MI 48377-1000 | 2017-10-03 |
| 1649631813 | S Park-davis Healthcare | Family Medicine | 30880 Beck Rd, Novi, MI 48377-1000 | 2016-03-15 |
| 1194045526 | Heather Koza | Family Medicine | 30880 Beck Rd, Novi, MI 48377-1000 | 2010-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679075758 | Andrea Campbell | Nurse Practitioner | 44000 W 12 Mile Rd Ste 113, Novi, MI 48377 | 2018-03-05 |
| 1811421928 | Michigan Eye and Contact Lens Pllc | Optometrist | 42081 14 Mile Road, Novi, MI 48377 | 2017-04-14 |
| 1336695691 | Deanna Lynne Klein | Speech-Language Pathologist | 44140 Fox Run Road, Novi, MI 48377 | 2016-08-28 |
| 1871940973 | Jaime Durante | Nurse Practitioner | 44070 W. 12 Mile Rd, Suite 100, Novi, MI 48377 | 2016-05-18 |
| 1508225624 | Trilogy Healthcare of Oakland II, LLC | Skilled Nursing Facility | 41795 W 12 Mile Road, Novi, MI 48377 | 2016-02-17 |
| 1144688854 | Hussein Azzam | Allergy & Immunology | 46325 W 12 Mile Rd Ste 215, Novi, MI 48377 | 2016-02-09 |
| 1598120164 | Nova Counseling Services Inc. | Counselor | 41650 Clemens Circle, Novi, MI 48377 | 2015-12-23 |
| 1891174587 | Reem Mariam Mansour | Occupational Therapist | 44125 West 12 Mile Rd E-123, Novi, MI 48377 | 2015-05-27 |
| 1154747095 | Ali Hassan Ismail | Dentist | 41920 Wolfe Pass, Novi, MI 48377 | 2014-03-17 |
| 1558703876 | Twelve Oaks Orthodontics Pllc | Dentist | 44110 W 12 Mile Rd, Suite 100, Novi, MI 48377 | 2013-07-29 |
| Find all providers in zip 48377 | ||||
| Taxonomy Code | 207RA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Adolescent Medicine |
| An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629505821 | Ultimate Service Care LLC | Internal Medicine | G3500 Flushing Rd Ste 200, Flint, MI 48504-4247 | 2017-05-18 |
| 1841312659 | Shahina Arif Motorwala | Internal Medicine | 2116 S Wayne Rd, Westland, MI 48186 | 2007-04-04 |
| 1609919323 | Mohammad Khalaf Batayneh | Internal Medicine | 32472 Schoolcraft Rd, Livonia, MI 48150-4309 | 2007-02-14 |
| 1255499257 | Zafer Obeid | Internal Medicine | 16921 W Warren Ave, Detroit, MI 48228-3505 | 2006-12-04 |
| 1306858980 | Thomas J W Bering, Md, PC | Internal Medicine | 2311 15 Mile Rd, Suite A, Sterling Heights, MI 48310-4812 | 2006-08-12 |
| 1174544050 | Lifetime Medical Associates, P.C. | Internal Medicine | 1701 South Blvd E Ste 250, Rochester Hills, MI 48307-6123 | 2006-07-23 |
| 1871554485 | Abraham Oommen | Internal Medicine | 200 W Center St, Alma, MI 48801-2207 | 2006-03-31 |
| 1225006745 | Jawahar L Tummala | Internal Medicine | 5084 W Pierson Rd, Flint, MI 48504-1390 | 2006-03-10 |
| 1538167572 | Jonathon K Nicholson | Internal Medicine | 393 Long Rapids Rd, Alpena, MI 49707-1317 | 2005-07-13 |
| 1316379936 | Iha Health Services Corporation | Internal Medicine | 111 N Huron St, Suite 200, Ypsilanti, MI 48197-2676 | 2013-08-06 |
| Find all providers with the same taxonomy | ||||
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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.