Individual
SEOK PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LAC
Contact information
Practice address
5550 STERRETT PL STE 303, COLUMBIA, MD 21044-2643
(410) 997-0390
(410) 885-4744
Mailing address
5550 STERRETT PL STE 303, COLUMBIA, MD 21044-2643
(410) 997-0390
(410) 885-4744
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
11889
CA
171100000X
Acupuncturist
Primary
U01592
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
443601600
MEDICAL ASSISTANCE
MD
01
—
C7VJS 92173902
CAREFIRST
MD
01
—
Y300-0001
CAREFIRST
DC
Enumeration date
07/13/2007
Last updated
10/12/2012
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