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Individual
DR. BRIAN DUKE PARK
Active
Individual
DR. BRIAN DUKE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A97247
CA
2086S0129X
Vascular Surgery Physician
ME 115350
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009175600
—
FL
01
—
14QW7
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/17/2007
Last updated
01/18/2017
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