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Individual

DR. DAVID H PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
263 FARMINGTON AVE, OB/GYN, FARMINGTON, CT 06030-6227
(860) 679-2792
(860) 679-8882
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
044773
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1649399494
CT
Enumeration date
03/29/2007
Last updated
09/28/2022
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