Grace Park, MD

NPI #1407410004 in Winston Salem, North Carolina

Provider Information

NPI Number: 1407410004
Entity Type: Individual
Name: Grace Park, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Credential: MD
Enumeration Date: Apr 29, 2019
Last Updated: Aug 25, 2022

Practice Location

Address: 2808 MAPLEWOOD AVE
City: Winston Salem
State: North Carolina
ZIP Code: 27103-4138
Phone: (336) 765-9000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Pediatrics	208000000X	Primary

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