DR. MICHAEL CHANKWON PARK (NPI# 1942427117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942427117 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL CHANKWON PARK |
| Credential | M.D., PH.D. |
| Practice Address |
516 Delaware St Se Clinic 1a Minneapolis MN 55455-0356 |
| Mailing Address |
420 Delaware St Se Mmc96, D429 Mail Minneapolis MN 55455-0341 |
| Practice Telephone | 6126246666 |
| Practice Fax Number | 6126240644 |
| Mailing Telephone | 6126264706 |
| Mailing Fax Number | 6126240644 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2014-12-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 58653 | MN | Allopathic & Osteopathic Physicians |
| N | 207T00000X | Neurological Surgery | TP326 | KY | Allopathic & Osteopathic Physicians |
| 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 |
| 1942204680 | Michael Park | Allergy & Immunology | 430 W Centre Ave, Portage, MI 49024-5304 | 2005-06-10 |
| 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 |
| Street Address |
516 DELAWARE ST SE CLINIC 1A |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55455-0356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912990060 | Anthony J Santiago | Psychiatry & Neurology | 516 Delaware St Se, Clinic 1a, Minneapolis, MN 55455-0356 | 2005-08-24 |
| 1225592249 | Thomas Bukowski | Registered Nurse | 516 Delaware St Se, Minneapolis, MN 55455-0356 | 2019-01-23 |
| 1407344278 | Hooi Pin Chew | Dentist | 516 Delaware St Se, 7th Floor Pwb, Minneapolis, MN 55455-0356 | 2018-04-27 |
| 1093223786 | Mai E Lor | Technician/Technologist | 516 Delaware St Se, Minneapolis, MN 55455-0356 | 2018-01-16 |
| 1063866820 | Kelsey Noah | Occupational Therapist | 516 Delaware St Se, Mmc106, Minneapolis, MN 55455-0356 | 2016-04-19 |
| 1467811125 | Kristin Schneller | Occupational Therapist | 516 Delaware St Se, Mmc106, Minneapolis, MN 55455-0356 | 2016-02-23 |
| 1013382472 | Brooke Kaney | Social Worker | 516 Delaware St Se, Clinic 1c, Minneapolis, MN 55455-0356 | 2015-12-09 |
| 1447632682 | Christian Larson | Optometrist | 516 Delaware St Se, Minneapolis, MN 55455-0356 | 2015-06-24 |
| 1770970485 | Sarah Maki | Internal Medicine | 516 Delaware St Se, Minneapolis, MN 55455 | 2015-04-20 |
| 1235525627 | Shanon Renee Harper | Nurse Practitioner | 516 Delaware St Se, Minneapolis, MN 55455-0356 | 2015-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715679 | Kara Biscobing | Nurse Anesthetist, Certified Registered | M Health Fairview Ummc East Bank 3-307, 500 Harvard Street, Minneapolis, MN 55455 | 2020-09-18 |
| 1982213237 | Yue Hu | Dentist | 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 | 2020-07-23 |
| 1952922148 | Jacob Laurence Tigner | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se, Mmc 284, Minneapolis, MN 55455 | 2020-04-29 |
| 1710507538 | Rachael Grundman | Student in an Organized Health Care Education/Training Program | 420 Delaware St, Mmc 395, Minneapolis, MN 55455 | 2020-04-22 |
| 1497375240 | Sanjay Dhawan | Student in an Organized Health Care Education/Training Program | 420 Delaware St. Se, Mmc 195, Minneapolis, MN 55455 | 2020-04-22 |
| 1508486549 | Dariel Andres Diaz | Student in an Organized Health Care Education/Training Program | 420 Se Delaware Street, Mmc 195, Minneapolis, MN 55455 | 2020-04-20 |
| 1275186280 | Kerem Ozturk | Radiology | B-226 Mayo Memorial Building, Mmc 292 420 Delaware Street S.e., Minneapolis, MN 55455 | 2019-07-18 |
| 1275194631 | Andres Jose Gonzalez Coba | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se Mmc 284, Minneapolis, MN 55455 | 2019-06-26 |
| 1841850278 | Brendan Andrew Schleyer | Dentist | 515 Delaware St Se, Div of Periodontology, Moos Tower, 7-368, Minneapolis, MN 55455 | 2019-06-18 |
| 1932767399 | Claire-audrey Y Bayan | Student in an Organized Health Care Education/Training Program | 420 Delaware Street, Mmc 98, Minneapolis, MN 55455 | 2019-05-31 |
| Find all providers in zip 55455 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770999716 | Gigante Acquisitions LLC | Neurological Surgery | 2215 Pillsbury Ave S, Minneapolis, MN 55404-3213 | 2014-07-10 |
| 1912136284 | Ann M Parr | Neurological Surgery | 516 Delaware St Se, Clinic 1a, Umphysicians Neurosurgery Clinic, Minneapolis, MN 55455 | 2009-07-08 |
| 1629289939 | Andrew Grande | Neurological Surgery | 420 Delaware St. Se, Mmc 96, D429 Mayo Memorial Building, Minneapolis, MN 55455 | 2007-05-25 |
| 1871695098 | Cornelius Hoktsim Lam | Neurological Surgery | 420 Delaware St Se # Mmc96, Minneapolis, MN 55455-0341 | 2006-09-01 |
| 1124044334 | Zhiyi Sha | Neurological Surgery | 420 Delaware Street S.e., Mmc 295, Minneapolis, MN 55455 | 2006-07-14 |
| 1114900966 | Eric John Decuir | Neurological Surgery | 913 E 26th St, Suite 305 Piper Building, Minneapolis, MN 55404-4515 | 2005-11-25 |
| 1932193083 | Daniel James Guillaume | Neurological Surgery | 516 Delaware Street Se, Ump Neurosurgery Clinic, Minneapolis, MN 55455 | 2005-09-06 |
| 1326334889 | Andrew S Venteicher | Neurological Surgery | 909 Fulton St Se, Minneapolis, MN 55455 | 2011-06-23 |
| 1770878993 | Joshua Lim | Neurological Surgery | 420 Delaware St Se, Mmc 96, Room D429, Minneapolis, MN 55455-0341 | 2011-06-15 |
| 1447550876 | Walter Lee Bailey | Neurological Surgery | 500 River St, Minneapolis, MN 55401 | 2010-11-02 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55455 |
Please comment or provide details below to improve the information on DR. MICHAEL CHANKWON 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.