Park, David J
Park, David J is an individual health care provider with primary practice located at 331 Olcott Dr Ste U3, White River Junction VT 05001-9601. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Park, David J can be contacted via phone (802) 295-6132.Contact Information
Primary practice address
331 Olcott Dr Ste U3
White River Junction VT 05001-9601
Phone: (802) 295-6132
Fax: (802) 295-1358
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 042-0010755 | Vermont |
Profile Details
| NPI number | 1790780211 |
|---|---|
| LBN Legal business name | Park, David J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Mar 29th, 2021 - about 3 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 | 1790780211 | NPPES |
| Vermont | MEDICAID | 1010649 | |
| Vermont | MEDICAID | 8000079 |
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