Individual
DR. DANIEL PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2285 ASQUITH AVE SW STE 200, MARIETTA, GA 30008
(770) 485-1554
Mailing address
2285 ASQUITH AVE SW STE 200, MARIETTA, GA 30008-6092
(770) 485-1554
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
79642
GA
208600000X
Surgery Physician
MD440792
PA
208600000X
Surgery Physician
ME122781
FL
208600000X
Surgery Physician
MT193449
PA
Other
Enumeration date
12/10/2008
Last updated
06/03/2018
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