Organization
I. JAMES PARK, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IN JOO JAMES PARK M.D. (PRESIDENT)
(410) 583-7670
Entity
Organization
Contact information
Practice address
5601 LOCH RAVEN BLVD, SUITE 400, BALTIMORE, MD 21239-2905
(410) 583-7670
(410) 583-7671
Mailing address
PO BOX 9819, BALTIMORE, MD 21284-9819
(410) 583-7670
(410) 583-7671
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D0004802
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025431200
—
MD
01
—
D48330
UPIN
MD
Enumeration date
12/17/2009
Last updated
12/17/2009
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