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MINJAE PARK
NPI 1649036104
Student in an Organized Health Care Education/Training Program in Fort Gordon, GA

Active since February 22, 2024
300 EAST HOSPITAL ROAD, FORT GORDON, GA 30905(706) 787-2090 Get Directions Write a Review

NPPES record last updated: February 22, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Minjae Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MINJAE PARK (NPI 1649036104) is an individual student in an organized health care education/training program in Fort Gordon, Georgia and active in the NPI registry since February 2024.

NPPES Registry Identity

NPI1649036104
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMINJAE PARK
Location Address300 EAST HOSPITAL ROADFort Gordon, GA 30905-5650
Mailing Address300 East Hospital RoadFort Gordon, GA 30905-5650 · Fax (706) 787-1745
Phone(706) 787-2090
Sole ProprietorNo
Enumeration DateFebruary 22, 2024
NPPES CertifiedFebruary 20, 2024
✔ NPI 1649036104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
300 EAST HOSPITAL ROAD, Fort Gordon, GA 30905
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SELENA YAKABE DO
Student in an Organized Health Care Education/Training Program
300 EAST HOSPITAL ROAD
FORT GORDON, GA 30905
Richmond County (706) 787-5811
LIBERTY CAITLYN LESTER DO
Student in an Organized Health Care Education/Training Program
300 EAST HOSPITAL ROAD
FORT EISENHOWER, GA 30905
Richmond County (706) 787-9399
DR. GARY RYAN HANN PSY. D.
Psychologist (Clinical)
300 EAST HOSPITAL ROAD
FORT GORDON, GA 30905
Richmond County (706) 787-8671
RHIANNA FLOHR
Student in an Organized Health Care Education/Training Program
300 EAST HOSPITAL ROAD
FORT GORDON, GA 30905
Richmond County (706) 787-5622
ANDREW ANKLOWITZ MD
Student in an Organized Health Care Education/Training Program
300 EAST HOSPITAL ROAD
FORT GORDON, GA 30905
Richmond County (706) 787-5811
CHRISTOPHER WESTON MD
Family Medicine
300 EAST HOSPITAL ROAD
FORT GORDON, GA 30905
Richmond County (706) 787-1647
PAUL JOHANN STUEVE MD
Internal Medicine
300 EAST HOSPITAL ROAD
FORT GORDON, GA 30905
Richmond County (913) 682-2000
DR. AARON WILLIAM GRAYSON MD
Student in an Organized Health Care Education/Training Program
300 EAST HOSPITAL ROAD
FORT GORDON, GA 30905
Richmond County (706) 787-9358

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Minjae Park's NPI number?

The NPI number for Minjae Park is 1649036104. It was assigned to this individual provider in the NPPES registry on February 22, 2024.

Where is Minjae Park located?

Minjae Park practices at 300 East Hospital Road, Fort Gordon, GA 30905. The listed phone number is (706) 787-2090.

What is Minjae Park's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Minjae Park was last updated on February 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.