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General NPI Number Information
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NPI Number | 1285626887
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Entity Type | Individual
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Provider Name | DONG HEE PARK M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 719 N BRIDGE ST
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City | ELKTON
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State | MD
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Zip | 21921-5309
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Country | US
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Telephone | 410-398-2700
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Fax | 410-620-1249
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Provider Business Mailing Address
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Address Line | 719 N BRIDGE ST
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City | ELKTON
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State | MD
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Zip | 21921-5309
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Country | US
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Telephone | 410-398-2700
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Fax | 410-620-1249
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | D0046451
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License Number State | MD
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