Park, Thomas

Park, Thomas is an sole proprietor health care provider with primary practice located at 23077 Greenfield #430 , Southfield MI 48075. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Park, Thomas can be contacted via phone (248) 552-0044.

Contact Information

Primary practice address
23077 Greenfield #430 Southfield MI 48075
Fax: (248) 423-7777
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X 040933 Michigan
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 4301040933 Michigan

Profile Details

NPI number 1629169412
LBN Legal business name Park, Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2006
Last updated Aug 16th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629169412 NPPES
Michigan Other M13298001 PTAN

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