Provider Demographics
NPI:1639675754
Name:PARK, SUMIN (MD)
Entity Type:Individual
Prefix:
First Name:SUMIN
Middle Name:
Last Name:PARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 W GERMANTOWN PIKE STE 220
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4261
Mailing Address - Country:US
Mailing Address - Phone:484-622-7940
Mailing Address - Fax:484-622-7950
Practice Address - Street 1:609 W GERMANTOWN PIKE STE 220
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4261
Practice Address - Country:US
Practice Address - Phone:484-622-7940
Practice Address - Fax:484-622-7950
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD478427207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology