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Individual

JOHN I PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
109 CROSSROADS RD, SUITE 6, SCOTTDALE, PA 15683-2458
(724) 887-7421
(724) 887-4145
Mailing address
109 CROSSROADS ROAD, SUITE 6, SCOTTDALE, PA 15683
(724) 887-7421
(724) 887-4145

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD034829E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0011173760007
PA
01
197526
HIGHMARK
Enumeration date
02/05/2007
Last updated
07/08/2007
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