Individual
DR. SUNG GOHN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2621 GROVE AVENUE, RICHMOND, VA 23220-4300
(804) 254-5100
Mailing address
DEPT 1041 PO BOX 740209, ATLANTA, GA 30374-0209
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101030177
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010032741
—
VA
Enumeration date
05/24/2006
Last updated
05/05/2009
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