Individual
BRIAN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20010 CENTURY BLVD, SUITE 200, GERMANTOWN, MD 20874-1115
(240) 686-2300
Mailing address
20010 CENTURY BLVD, SUITE 200, GERMANTOWN, MD 20874-1115
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C06204
MD
Other
Enumeration date
09/02/2016
Last updated
09/02/2016
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