Individual
MATTHEW PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 HOSPITAL DR, SUITE 305 TATE CENTER, GLEN BURNIE, MD 21061-5805
(410) 768-3701
(410) 766-0881
Mailing address
305 HOSPITAL DR, SUITE 305 TATE CENTER, GLEN BURNIE, MD 21061-5805
(410) 768-3701
(410) 766-0881
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
D47575
MD
207RI0200X
Infectious Disease Physician
D47575
MD
207RP1001X
Pulmonary Disease Physician
Primary
D0047575
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405189100
—
MD
Enumeration date
04/20/2006
Last updated
09/18/2008
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