Individual
JEREMY PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
MD
Contact information
Practice address
1100 ALABAMA AVE SE, WASHINGTON, DC 20032-4542
(202) 299-5100
Mailing address
1126 BUCHANAN ST, MC LEAN, VA 22101-2943
(703) 638-9220
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MTL500002959
DC
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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