| Dong Soo Park, MD | |
|
485 W Market St, Tiffin, OH 44883 | |
| (419) 447-3130 | |
| (419) 447-3155 |
| Full Name | Dong Soo Park |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 485 W Market St, Tiffin, Ohio |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699700021 | NPI | - | NPPES |
| 0359400 | Medicaid | OH | |
| 000000024792 | Other | OH | BCBS GROUP PIN |
| 9122391 | Other | OH | GROUP |
| CK3646 | Other | OH | MEDICARE RR GROUP PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 35041526P (Ohio) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dong Soo Park, MD Po Box 1108, Ann Arbor, MI 48106-1108 Ph: (734) 677-7400 | Dong Soo Park, MD 485 W Market St, Tiffin, OH 44883 Ph: (419) 447-3130 |
Kommula Chiranjeevi Rao, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 485 W Market St, Tiffin, OH 44883 Phone: 419-447-3130 Fax: 419-448-3155 | |
Jorge Cepeda, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 485 W Market St, Tiffin, OH 44883 Phone: 419-447-3130 Fax: 419-448-3155 | |
Jung Joo Suh, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 485 W Market St, Tiffin, OH 44883 Phone: 419-447-3130 Fax: 419-447-3155 |