# DR. BRIAN DUKE PARK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1508918616
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | A97247 | CA | Yes |
| 2086S0129X | Vascular Surgery Physician | ME 115350 | FL | — |

## Other

- **Enumeration date:** 01/17/2007
- **Last updated:** 01/18/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 009175600 | — | FL |
| 01 | — | 14QW7 | BLUE CROSS BLUE SHIELD | FL |