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Contact Information

DONG S PARK, MD
485 W MARKET ST
TIFFIN, OH44883
 Phone: 419-447-3130
 Fax: 419-447-3155
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for DONG S PARK · (Male)

NPI Number 1699700021
Status Active
Credentials MD
Entity Individual
Enumeration date 07/12/2006
Last updated 11/02/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 35041526P
  • OH Medicaid 0359400
  • OH Other 000000024792 BCBS GROUP PIN
  • OH Other 9122391 GROUP
  • OH Other CK3646 MEDICARE RR GROUP PIN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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