Individual
JEFFREY PARK
Active
Individual
JEFFREY PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125065218
IL
207RC0000X
Cardiovascular Disease Physician
2020-04840
NC
207RI0011X
Interventional Cardiology Physician
Primary
DR.0068559
CO
Other
Enumeration date
03/27/2014
Last updated
08/25/2022
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