Park, Jung I.
Park, Jung I. is an sole proprietor health care provider with primary practice located at 8825 Crestwood Ave , Munster IN 46321-2711. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Park, Jung I. can be contacted via phone (219) 746-9600.Contact Information
Primary practice address
8825 Crestwood Ave
Munster IN 46321-2711
Phone: (219) 746-9600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 01032400A | Indiana |
Profile Details
| NPI number | 1124006523 |
|---|---|
| LBN Legal business name | Park, Jung I. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 5th, 2006 |
| Last updated | Apr 19th, 2013 - about 12 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 | 1124006523 | NPPES |
| Indiana | MEDICAID | 234393 |
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