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Individual

DR. CHONG SHICK PARK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
143 E 2ND ST, ERIE, PA 16507-1501
(814) 878-1294
(814) 878-1399
Mailing address
143 E 2ND ST, ERIE, PA 16507-1501
(814) 878-1294
(814) 878-1399

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD019338E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0605574
PA
Enumeration date
07/22/2005
Last updated
07/08/2007
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