Individual
DR. JOHN STANITSKI PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2002 MEDICAL PKWY, SUITE 235, ANNAPOLIS, MD 21401-3046
(410) 266-2770
(410) 841-6251
Mailing address
2002 MEDICAL PKWY, SUITE 235, ANNAPOLIS, MD 21401-3046
(410) 266-2770
(410) 841-6251
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A95402
CA
2085R0202X
Diagnostic Radiology Physician
Primary
D0058193
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021965A80
AAD PG COUNTY
MD
01
—
10690030
BCBS
MD
05
—
412620300
—
MD
01
—
545LQ923
SHIPLEYS MEDICARE
MD
01
—
CN6292
RR MEDICARE SHIPLEYS
MD
01
—
P00471895
PTAN
MD
01
—
Q932
AAD AA COUNTY
MD
01
—
S629Q703
MEDICARE ARA PTAN
MD
Enumeration date
07/27/2006
Last updated
12/16/2010
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