Park, Soo Woong

Park, Soo Woong is an sole proprietor health care provider with primary practice located at 10680 Main St Ste 130, Fairfax VA 22030-3811. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Park, Soo Woong can be contacted via phone (703) 273-6802.

Contact Information

Primary practice address
10680 Main St Ste 130 Fairfax VA 22030-3811
Phone: (703) 273-6802
Fax: (703) 273-3960
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 0101029694 Virginia

Profile Details

NPI number 1205833910
LBN Legal business name Park, Soo Woong
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2005
Last updated Nov 13th, 2009 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205833910 NPPES
Virginia MEDICAID 6075550

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