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
Phone: (248) 552-0044
Fax: (248) 423-7777
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1629169412 | NPPES |
Michigan | Other | M13298001 | PTAN |
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