Individual
CHOON MYONG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 955-1686
Mailing address
PO BOX 64588, BALTIMORE, MD 21264-4588
(410) 933-6401
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
D18745
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
714171800
—
MD
Enumeration date
06/07/2006
Last updated
09/10/2010
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