Individual
MR. STEVEN EARL PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
10506 MONTGOMERY ROAD, SUITE 302, CINCINNATI, OH 45242
(513) 865-5120
(513) 865-5121
Mailing address
10506 MONTGOMERY ROAD, SUITE 302, CINCINNATI, OH 45242
(513) 865-5120
(513) 865-5121
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
29550
KY
208600000X
Surgery Physician
35065137P
OH
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
29550
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
35065137P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000005455
ANTHEM
—
05
—
0932816
—
OH
01
—
1820063
UNITED HEALTHCARE
—
05
—
200058030A
—
IN
01
—
310804060038
CARESOURCE
—
05
—
64951494
—
KY
01
—
65137
CHOICE CARE/HUMANA
—
01
—
8330
KY BCBS
—
Enumeration date
07/10/2006
Last updated
03/25/2014
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