Individual
DR. CHAN J. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 S PLUM ST, VERMILLION, SD 57069-3346
(605) 624-9111
(605) 624-6636
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5009
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7301822
—
SD
Enumeration date
05/04/2006
Last updated
09/12/2013
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