Park, Chan S.
Park, Chan S. is an individual health care provider with primary practice located at Michumi, Pllc Dba Med Express Of Williamsburg, Va 120 Monticello Ave, Williamsburg VA 23185. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Park, Chan S. can be contacted via phone (757) 564-3627.Contact Information
Primary practice address
Michumi, Pllc Dba Med Express Of Williamsburg, Va 120 Monticello Ave
Williamsburg VA 23185
Phone: (757) 564-3627
Fax: (757) 564-6449
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 0101043881 | Virginia |
Profile Details
| NPI number | 1619940681 |
|---|---|
| LBN Legal business name | Park, Chan S. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 9th, 2006 |
| Last updated | Aug 7th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619940681 | NPPES |
| Virginia | MEDICAID | 010094321 | |
| Virginia | Other | P00153223 |
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