Park, Gregory
Park, Gregory is an individual health care provider with primary practice located at 30 N Church St , Wailuku HI 96793-1600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Park, Gregory can be contacted via phone (808) 244-7627.Contact Information
Primary practice address
30 N Church St
Wailuku HI 96793-1600
Phone: (808) 244-7627
Fax: (808) 242-6696
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD3915 | Hawaii |
Profile Details
| NPI number | 1861497596 |
|---|---|
| LBN Legal business name | Park, Gregory |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2005 |
| 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 | 1861497596 | NPPES |
| Hawaii | MEDICAID | 04550602 |
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