Park, Adrian E.
Park, Adrian E. is an individual health care provider with primary practice located at 11110 Medical Campus Rd Ste 143 , Hagerstown MD 21742-6755. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Park, Adrian E. can be contacted via phone (301) 714-4350.Contact Information
Primary practice address
11110 Medical Campus Rd Ste 143
Hagerstown MD 21742-6755
Phone: (301) 714-4350
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | D60890 | Maryland |
Profile Details
| NPI number | 1376567099 |
|---|---|
| LBN Legal business name | Park, Adrian E. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2006 |
| Last updated | Dec 5th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376567099 | NPPES |
| Maryland | Other | 240838 | KAISER |
| Maryland | Other | Y7920001 | KAISER |
| Maryland | Other | 2114812 | KAISER |
| Maryland | Other | P01240294 | KAISER |
| Maryland | MEDICAID | 403374400 | KAISER |
| Maryland | Other | 0088 | KAISER |
| Maryland | Other | 82499 | KAISER |
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