Individual provider · Type 1 NPI

Maria A. Park, P.A.

Medical Physician Assistant · Milwaukee, WI

NPI number 1104263979 Active

Practice location

9200 W Wisconsin Avenue, Colorectal Surgery
Milwaukee, WI 53226-3522

Call (414) 955-5783 Map

Fax (414) 955-0087

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X3119-23 (WI)
Surgical Physician Assistant 363AS0400X3119-23 (WI)
Medical Physician Assistant Primary 363AM0700X3119-23 (WI)

Medical Physician Assistant: Definition to come...

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About NPI 1104263979

Maria A. Park, P.A.'s National Provider Identifier is 1104263979, issued on Jun 3, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Milwaukee, WI. The record was last updated on Jan 8, 2024.