Individual
FREDERICK KIM PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4008 CAPITAL DRIVE, ROCKY MOUNT, NC 27804
(252) 937-5003
(252) 937-3020
Mailing address
4008 CAPITAL DRIVE, ROCKY MOUNT, NC 27804
(252) 937-5003
(252) 937-3020
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
36793
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407964547
—
NC
Enumeration date
08/28/2006
Last updated
08/11/2025
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