Dr Chan S Park, MD | |
Michumi, Pllc Dba Med Express Of Williamsburg, Va, 120 Monticello Ave, Williamsburg, VA 23185 | |
(757) 564-3627 | |
(757) 564-6449 |
Full Name | Dr Chan S Park |
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Gender | Male |
Speciality | Emergency Medicine |
Location | Michumi, Pllc Dba Med Express Of Williamsburg, Va, Williamsburg, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619940681 | NPI | - | NPPES |
010094321 | Medicaid | VA | |
P00153223 | Other | VA | RRMED |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 0101043881 (Virginia) | Primary |
Entity Name | Michumi Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255388021 PECOS PAC ID: 5193784395 Enrollment ID: O20041004001110 |
Mailing Address | Practice Location Address |
---|---|
Dr Chan S Park, MD Po Box 5508, Virginia Beach, VA 23471-0508 Ph: (757) 340-3489 | Dr Chan S Park, MD Michumi, Pllc Dba Med Express Of Williamsburg, Va, 120 Monticello Ave, Williamsburg, VA 23185 Ph: (757) 564-3627 |
Susan Marie Lessner-boesler, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 124 Oak Holw, Williamsburg, VA 23188 Phone: 757-206-6595 | |
Dr. Stephen Grimes, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 301 Monticello Ave, Williamsburg, VA 23185 Phone: 757-259-6000 | |
Thomas Camp, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 100 Sentara Cir, Williamsburg, VA 23188 Phone: 757-984-6000 | |
David I Cohen, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1500 Commonwealth Ave, Williamsburg, VA 23185 Phone: 757-585-2250 Fax: 757-903-2285 | |
Samuel Anthony John Tabacchi, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1500 Commonwealth Ave, Williamsburg, VA 23185 Phone: 757-585-2000 | |
Dr. Karen Link, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 301 Monticello Ave, Williamsburg, VA 23185 Phone: 757-259-6000 | |
Dr. David P Johnson, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1500 Commonwealth Ave, Williamsburg, VA 23185 Phone: 757-585-2250 Fax: 757-903-2285 |