Park, Chan Dong
Park, Chan Dong is an individual health care provider with primary practice located at 1002 Sushruta Dr , Martinsburg WV 25401-8897. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Park, Chan Dong can be contacted via phone (304) 263-0913.Contact Information
Primary practice address
1002 Sushruta Dr
Martinsburg WV 25401-8897
Phone: (304) 263-0913
Fax: (304) 267-2917
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 17219 | West Virginia |
Profile Details
| NPI number | 1407815665 |
|---|---|
| LBN Legal business name | Park, Chan Dong |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 17th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
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 | 1407815665 | NPPES |
| West Virginia | MEDICAID | 0075530000 |
Popular Providers
-
Jones, Dawn
99 Tavern Rd , Martinsburg WV 25401-2890 -
Rudolph, Karen Jon
1002 Sushruta Drive , Martinsburg WV 25401 -
Owunna, Anthony
99 Tavern Rd , Martinsburg WV 25401-2890 -
Fierer, Jonathan E
510 Butler Ave , Martinsburg WV 25401-9990 -
Mahoney, Patricia
99 Tavern Rd , Martinsburg WV 25401-2890 -
Menon, Suresh K
1000 Tavern Rd Suite 400, Martinsburg WV 25401-2845 -
Park, Jane Gerke
1002 Sushruta Dr , Martinsburg WV 25401-8897 -
Xie, Jianming
510 Butler Ave Geriatrics/Long Term Care Service, Martinsburg WV 25401-9990