Individual
MR. GERALD Y PARK
Active
Individual
MR. GERALD Y PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
0432487
KS
208800000X
Urology Physician
Primary
2000158331
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27244012
BCBS
—
01
—
340018272
RAILROAD MEDICARE
—
Enumeration date
05/12/2006
Last updated
04/12/2021
Update your record
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