Individual provider · NPI-1
Chan Hoon Park, MD
Family Medicine · Slatersville, RI
NPI number1700092103
StatusActive
Last updated in NPPESFeb 26, 2008
Details
- NPI
- 1700092103
- Entity type
- Individual (NPI-1)
- Name
- Chan Hoon Park
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 15, 2007
- Last updated
- Feb 26, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | MD 5083 | RI | Yes |
Practice location
905 Victory HwySlatersville, RI 02876
Phone 401-762-2728 · Fax 401-762-0473
Mailing address
905 Victory HwyPo Box 177
Slatersville, RI 02876
Phone 401-762-2728 · Fax 401-762-0473
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.