Individual
SUN A. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1480 N MAIN ST, STE A, MADISON, VA 22727-3093
(540) 948-6743
(540) 948-4527
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
003652
NY
207R00000X
Internal Medicine Physician
Primary
0101257545
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03264431
—
NY
Enumeration date
09/09/2008
Last updated
02/16/2015
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