Individual
SUE Y PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 N BEAUREGARD ST, SUITE 200, ALEXANDRIA, VA 22311-1723
(703) 212-6600
(703) 931-0961
Mailing address
1500 N BEAUREGARD ST, SUITE 200, ALEXANDRIA, VA 22311-1723
(703) 212-6600
(703) 931-0961
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101056410
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6719694
—
VA
Enumeration date
03/17/2006
Last updated
02/09/2011
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