Individual
STACY CAIN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1215 LEE ST, BOX 800744, CHARLOTTESVILLE, VA 22908-0816
(434) 924-1931
(434) 243-5770
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
0101272605
VA
208M00000X
Hospitalist Physician
0101272605
VA
Other
Enumeration date
04/04/2015
Last updated
08/02/2021
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