Justin Park, M.D.
Orthopaedic Surgery, Orthopaedic Surgery of the Spine in Glen Burnie, MD. Individual provider (NPI-1).
NPI number1265625941
StatusActive
Last updated in NPPESApr 15, 2013
Details
- NPI
- 1265625941
- Entity type
- Individual (NPI-1)
- Name
- Justin Park
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 25, 2007
- Last updated
- Apr 15, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207XS0117X | Orthopaedic Surgery, Orthopaedic Surgery of the Spine | D0073546 | MD | Yes |
| 207XS0117X | Orthopaedic Surgery, Orthopaedic Surgery of the Spine | 43955 | KY |
Practice location
1600 Crain Hwy SSuite 401
Glen Burnie, MD 21061-5577
Phone 410-768-5050 · Fax 410-768-7830
Mailing address
1600 Crain Hwy SSuite 401
Glen Burnie, MD 21061-5577
Phone 410-768-5050 · Fax 410-768-7830
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