Individual
PETER CHUNGHYUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
580 COURT ST, KEENE, NH 03431-1718
(603) 354-5400
Mailing address
580 COURT ST, KEENE, NH 03431-1729
(603) 354-5400
(828) 257-4738
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
042-0009719
VT
207Q00000X
Family Medicine Physician
2022-011755
NC
207Q00000X
Family Medicine Physician
Primary
EL12775
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN1844
—
VT
01
—
2022-01755
NORTH CAROLINA MEDICAL LICENSE
NC
Enumeration date
07/09/2006
Last updated
09/25/2023
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