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Contact Information

WOOSUK PARK, MD
10400 75TH ST
KENOSHA, WI53142
 Phone: 629-487-0002
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for WOOSUK PARK · (Male)

NPI # 1366453656
Status Active
Credentials MD
Entity Individual
Enumeration date 08/11/2006
Last updated 10/15/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 49236
  • WI Medicaid 34878800
  • WI Other 391264986 TAX ID
Hospital affiliation(s)
  • AURORA MED CTR KENOSHA - (Acute Care)
    10400 75TH ST
    KENOSHA, WI 53142
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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