Heedong Park, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

HP031219 Issued in MI

Practice address

9463 Holly Rd
Suite 102
Grand Blanc, MI 48439-8351

Phone

(810) 579-2600

Fax

(810) 579-2601

NPI assigned

Apr 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• General Surgeons of Flint, P.C.

  • Trauma Surgery Physician
  • Grand Blanc, MI
  • NPI 1952362030
  NPD (past)
• Nephrology & Internal Medicine PC

  • Specialist
  • Flint, MI
  • NPI 1730190596
  NPD (past)

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1518929082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9463 HOLLY RD",
            "address_2": "SUITE 102",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398351",
            "telephone_number": "810-579-2600",
            "fax_number": "810-579-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9463 HOLLY RD",
            "address_2": "SUITE 102",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398351",
            "telephone_number": "810-579-2600",
            "fax_number": "810-579-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HEEDONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "HP031219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1158145",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Painless Dental Care PLC
• Lindsay Palazzola
• Tristan Palleschi, DDS
• Chloe Palovich
• Ananda Vishnu Pandurangadu, M.D.
• Jayna Parkinson
• Giovanni Peter Parochetti, PMHNP -BC
• Thomas Paron, DDS, MS
• Jill Evon Parr
• Karla Marie Pate

• Surgery Physician in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.