Provider Demographics
NPI:1801023494
Name:PARK, PATSY W (MD)
Entity type:Individual
Prefix:
First Name:PATSY
Middle Name:W
Last Name:PARK
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1545 ORCHARD VILLAS AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4339
Mailing Address - Country:US
Mailing Address - Phone:919-385-2840
Mailing Address - Fax:919-385-2836
Practice Address - Street 1:1545 ORCHARD VILLAS AVE STE 110
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4339
Practice Address - Country:US
Practice Address - Phone:919-385-2840
Practice Address - Fax:919-385-2836
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2020-07-01
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Provider Licenses
StateLicense IDTaxonomies
NC011822080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology