Park, Justin
Park, Justin is an individual health care provider with primary practice located at 1600 Crain Hwy S Suite 401, Glen Burnie MD 21061-5577. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, which is considered as his primary health care specialty. Park, Justin can be contacted via phone (410) 768-5050.Contact Information
Primary practice address
1600 Crain Hwy S Suite 401
Glen Burnie MD 21061-5577
Phone: (410) 768-5050
Fax: (410) 768-7830
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | 43955 | Kentucky |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | D0073546 | Maryland |
Profile Details
| NPI number | 1265625941 |
|---|---|
| LBN Legal business name | Park, Justin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2007 |
| Last updated | Apr 15th, 2013 - about 11 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 | 1265625941 | NPPES |
| Maryland | Other | 253616 | JHHC |
| Maryland | Other | 6831-0019 | JHHC |
| Maryland | Other | K007170 | JHHC |
| Maryland | MEDICAID | 231508400 | JHHC |
| Maryland | Other | 6029607 | JHHC |
| Maryland | Other | 9804676 | JHHC |
| Maryland | Other | 8543972 | JHHC |
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