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General NPI Number Information
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NPI Number | 1710446026
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Entity Type | Individual
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Provider Name | WILLIAM YOUNG PARK MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2019
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1133 21ST ST NW BUILDING 2 5TH FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20036-3390
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Country | US
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Telephone | 202-416-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 593 EDDY ST STE 240
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City | PROVIDENCE
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State | RI
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Zip | 02903-4923
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Country | US
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Telephone | 401-444-5034
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 280221
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License Number State | MA
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | D0103627
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License Number State | MD
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