Michelle M Park, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29441 Issued in AZ

Practice address

3410 N 4TH Ave
Phoenix, AZ 85013-3905

Phone

(602) 241-1944

Fax

(602) 241-1917

NPI assigned

Oct 25, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1376533943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 JUNIPER LN",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038014792",
            "telephone_number": "206-376-5769",
            "fax_number": "602-241-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 N 4TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133905",
            "telephone_number": "602-241-1944",
            "fax_number": "602-241-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "29441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Park, M.D.
• Jung K Park, M.D.
• Keun Hye Park
• Kwiok Gloria Park
• Michelle Hae-Min Park, DO
• Naomi Park, MD
• Sabrina Park
• Sara E.Q. Park, MD
• Sooyoung Park
• Stacy Park

• Internal Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.