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CAROLYN JEAN PARK MD NPI 1174917017


NPI Information

NPI: 1174917017
Provider Name: CAROLYN JEAN PARK, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
1237 HARDING PL
STE 3100
CHARLOTTE, NC
ZIP 28204
Phone: (704) 373-0212
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Carolyn Jean Park, MD is a cardiovascular disease internal medicine in Charlotte, NC with 9 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Carolyn Jean Park, MD NPI is 1174917017. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: DREXEL UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:2015

The provider's business location address is:

1237 HARDING PL
STE 3100
CHARLOTTE, NC
ZIP 28204
Phone: (704) 373-0212

The NPI 1174917017 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/27/2015 and was last updated on 12/20/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine2018-00986NORTH CAROLINANo
2207RC0000XInternal MedicineCardiovascular Disease2018-00986NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.