Individual
DR. JOHN MOONKEUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35.095909
OH
2086S0129X
Vascular Surgery Physician
Primary
26509
NE
2086S0129X
Vascular Surgery Physician
35.095909
OH
2086S0129X
Vascular Surgery Physician
40563
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025724800
—
NE
05
—
10026135100
—
NE
05
—
10026454700
—
NE
05
—
1023394665
—
IA
05
—
47068731713
—
NE
Enumeration date
10/27/2011
Last updated
09/23/2025
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