Individual
HAEJOE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MS
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 243-1455
(717) 531-0793
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD453182
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029773840001
—
PA
Enumeration date
05/22/2007
Last updated
08/06/2020
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