Active NPI
Sun Park, MD
- Psychiatry Physician
- Lincoln Park, MI
National Provider Identifier
1992737548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301035527
- Practice address
- 26184 W. Outer Dr
Lincoln Park, MI 48146-2084 - Phone
- (313) 389-7500
- NPI assigned
- Jul 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301035527 | MI | Primary |
Addresses
Primary practice location
26184 W. Outer Dr
Lincoln Park, MI 48146-2084
Mailing address
3885 Wabeek Lake Dr E
Bloomfield Hills, MI 48302-1259
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213747200000",
"number": "1992737548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3885 WABEEK LAKE DR E",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483021259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26184 W. OUTER DR",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "481462084",
"telephone_number": "313-389-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "SUN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-06",
"last_updated": "2008-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301035527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.