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1972704096
CHARLES PARK
CINCINNATI, OH
NPI
1972704096
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208600000X Surgery
(Licence: OH 35.126455)
Additional Taxonomies
208600000X Surgery
(Licence: MA 249748)
Enumeration Date
2007-05-29
Last Update Date
2018-03-13
Business Address
CHARLES PARK MD
234 GOODMAN ST
CINCINNATI, OH 45219-2364
Phone number: 513-475-8787
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Mailing Address
CHARLES PARK MD
PO BOX 636256 CENTRAL CREDENTIALING
CINCINNATI, OH 45263-6256
Phone number: 513-585-5506
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