MEDICARE: DR. SUYI PARK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D0059014	MD

General Provider Information

NPI Number	:	1932177904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUYI PARK MD

Provider Business Mailing Address
First Line	:	700 WASHINGTON BLVD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-2350
Country	:	US
Telephone Number	:	410-539-3360
Fax Number	:	410-752-3340

Provider Business Practice Location Address
First Line	:	700 WASHINGTON BLVD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-2350
Country	:	US
Telephone Number	:	410-539-3360
Fax Number	:	410-752-3340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	06/12/2020

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Directions to “ DR. SUYI PARK MD” Practice Location

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