DR. DANIEL BORAM PARK M.D. NPI 1730317397

NPI Information

NPI: 1730317397
Provider Name: DR. DANIEL BORAM PARK, M.D.
Classification: Pediatrics - 2080P0204X
Specialization: Pediatric Emergency Medicine
Entity Type: Individual
PECOS Registration: Yes
Address: 171 ASHLEY AVE
CHARLESTON, SC
ZIP 29425
Phone: (843) 792-1414

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NPI Details

DR. Daniel Boram Park, M.D. is a pediatric emergency medicine pediatrics in Charleston, SC. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. DR. Daniel Boram Park, M.D. NPI is 1730317397. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

171 ASHLEY AVE
CHARLESTON, SC
ZIP 29425-908
Phone: (843) 792-1414

The NPI 1730317397 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 6/22/2009 and was last updated on 1/18/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		34501	SOUTH CAROLINA	No
2	2080P0204X	Pediatrics	Pediatric Emergency Medicine	34501	SOUTH CAROLINA	Yes
3	390200000X	Student in an Organized Health Care Education/Training Program			CONNECTICUT	No

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: 11/21/2025

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