Individual
JAKOB PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
96 CAMPUS DR, SCARBOROUGH, ME 04074-7163
(207) 885-9905
(207) 396-5600
Mailing address
96 CAMPUS DR, SCARBOROUGH, ME 04074-7163
(207) 885-9905
(207) 396-5600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
67469
CT
207R00000X
Internal Medicine Physician
A178342
CA
207R00000X
Internal Medicine Physician
MD30217
ME
207RC0000X
Cardiovascular Disease Physician
A178342
CA
207RC0000X
Cardiovascular Disease Physician
Primary
MD30217
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2018
Last updated
03/05/2026
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