| Doctor Name: | CHUNGSUK K. PARK |
| NPI Number: | 1528326741 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 4301039184 |
| Business Practice Address: | 25676 Island Lake Dr Novi, MI - 483742175 |
| Business Phone Number: | 2484491726 |
| Business Fax Number: | |
| Mailing Address: | 25676 Island Lake Dr, NOVI |
| State: | MI |
| Postal Code: | 483742175 |
| Phone Number: | 2484491726 |
| Fax Number: | |
| NPI Enumeration Date: | 04/25/2012 |
| NPI Last Update Date: | 04/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301039184 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |