Individual
MR. KYUNG SOON PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
575 COAL VALLEY ROAD, SUITE 504, CLAIRTON, PA 15025-3729
(412) 469-7900
(412) 469-7919
Mailing address
575 COAL VALLEY ROAD, SUITE 504, CLAIRTON, PA 15025-3729
(412) 469-7900
(412) 469-7919
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD067920L
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD-067920-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017467910002
—
PA
Enumeration date
08/19/2005
Last updated
10/08/2020
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