Michael Park, MD is a
Allergy & Immunology physician based in Portage, Michigan. Michael Park is licensed to practice in Michigan (license number 4301063179) and his current practice location is 430 W Centre Ave, Portage, Michigan. He can be reached at his office (for appointments etc.) via phone at
(269) 321-6673.
NPI number for Michael Park is 1942204680 and his current mailing address is 430 W Centre Ave, Portage, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1942204680.
Physician's Profile
Full Name | Michael Park |
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Gender | Male |
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Speciality | Allergy & Immunology |
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Location | 430 W Centre Ave, Portage, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1942204680
- Provider Enumeration Date: 06/10/2005
- Last Update Date: 07/16/2007
Medical Identifiers
Medical identifiers for Michael Park such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1942204680 | NPI | - | NPPES |
4111376 | Medicaid | MI | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207K00000X | Allergy & Immunology | 4301063179 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Michael Park is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Michael Park, MD 430 W Centre Ave, Portage, MI 49024-5304 Ph: (269) 321-6673 | Michael Park, MD 430 W Centre Ave, Portage, MI 49024-5304 Ph: (269) 321-6673 |
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