MICHAEL PARK (NPI# 1942204680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942204680 |
| Entity Type | Individual |
| Full Name | MICHAEL PARK |
| Credential | M.D. |
| Practice Address |
430 W Centre Ave Portage MI 49024-5304 |
| Practice Telephone | 2693216673 |
| Practice Fax Number | 2693245594 |
| Mailing Telephone | 2693216673 |
| Mailing Fax Number | 2693245594 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2007-07-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 4301063179 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4111376 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902393390 | Michael Sehyun Park | Pharmacist | 2920 Inland Empire Blvd Ste 112, Ontario, CA 91764-6581 | 2018-04-20 |
| 1932289030 | Michael Kwansup Park | Physical Medicine & Rehabilitation | 1940 Webster St, 2nd Floor, Oakland, CA 94612-2920 | 2006-10-16 |
| 1942229505 | Michael K Park | Family Medicine | 3445 Woody Crk, Evergreen, CO 80439-7996 | 2006-07-18 |
| 1730135641 | Michael David Park | Dentist | 1200 N Vermont Ave, Suite B, Los Angeles, CA 90029-1760 | 2006-05-25 |
| 1013514777 | Michael Park | Case Manager/Care Coordinator | 515 Columbia Ave Ste 200, Los Angeles, CA 90017-1209 | 2020-10-06 |
| 1457906257 | Michael Y Park | Dentist | 12793 Laurel Bowie Rd, Laurel, MD 20708-2606 | 2019-08-08 |
| 1831611177 | Michael Park | Student in an Organized Health Care Education/Training Program | 350 Engle St, Englewood, NJ 07631-1808 | 2017-07-07 |
| 1194270231 | Michael H Park | Dentist | 330 W 58th St, Apt 9p, New York, NY 10019-1827 | 2016-08-18 |
| 1225489347 | Michael Adam Park | Optometrist | 1801 N 3rd St, Coeur D Alene, ID 83814-3400 | 2016-06-30 |
| 1912353061 | Michael Park | Counselor | 1411 Sw Morrison St Ste 310, Portland, OR 97205-1945 | 2016-05-09 |
| Street Address |
430 W CENTRE AVE |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-5304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487100350 | Park Allergy Center PC | Allergy & Immunology | 430 W Centre Ave, Portage, MI 49024-5304 | 2016-08-30 |
| 1700031952 | Joon H Park | General Practice | 430 W Centre Ave, Portage, MI 49024 | 2008-12-01 |
| 1649234980 | Paragon Health, P.C. | Allergy & Immunology | 430 W Centre Ave, Portage, MI 49024-5304 | 2006-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295065126 | Richard Kurt Vonmaur | Allergy & Immunology | 10653 Sudan St, Portage, MI 49002-7373 | 2009-12-24 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1487100350 | Park Allergy Center PC | Allergy & Immunology | 430 W Centre Ave, Portage, MI 49024-5304 | 2016-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144688854 | Hussein Azzam | Allergy & Immunology | 46325 W 12 Mile Rd Ste 215, Novi, MI 48377 | 2016-02-09 |
| 1417360660 | Allergy & Asthma Physicians of Troy, P.C. | Allergy & Immunology | 4600 Investment Drive, Suite # 110, Suite # 110, Troy, MI 48098-6366 | 2014-06-05 |
| 1861834095 | Herald Allen Habenicht | Allergy & Immunology | 10516 Range Line Rd, Berrien Springs, MI 49103-9203 | 2013-07-30 |
| 1386991461 | Lee D. Baylis, M.d. Pllc | Allergy & Immunology | 5825 S Main St Ste 203, Clarkston, MI 48346-2983 | 2012-08-08 |
| 1134485139 | James Austin Womack | Allergy & Immunology | 2310 W Mcnichols Rd, Detroit, MI 48221 | 2012-04-04 |
| 1023380797 | Leonard Samuel Gell | Allergy & Immunology | 7650 Conservation St Ne, Ada, MI 49301-9522 | 2012-01-27 |
| 1700038684 | James C Breneman | Allergy & Immunology | 10571 Miller Dr, Galesburg, MI 49053-8607 | 2008-10-22 |
| 1245493527 | Rachel Karman Kado | Allergy & Immunology | 20228 Farmington Rd, Livonia, MI 48152-1412 | 2008-07-07 |
| 1992979223 | Rasem David Ghannam | Allergy & Immunology | 15386 Mcleans, Spring Lake, MI 49456-2129 | 2008-04-17 |
| 1326211129 | Brian Burgess | Allergy & Immunology | 2433 Byron Center Ave Sw, 203, Wyoming, MI 49519-2196 | 2008-04-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MICHAEL PARK.
| 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.