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General NPI Number Information
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NPI Number | 1194381806
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Entity Type | Individual
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Provider Name | HYUN C PARK MD
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Gender | Female
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 07/21/2024
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Provider Practice Location Address
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Address Line | 1701 N GEORGE MASON DR
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City | ARLINGTON
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State | VA
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Zip | 22205-3610
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Country | US
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Telephone | 703-717-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 14708 WILDFLOWER CT
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City | CENTREVILLE
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State | VA
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Zip | 20120-1368
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Country | US
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Telephone | 980-621-5563
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0116032813
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101275893
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | VA
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