IndividualActive
Chan Park, MD
NPI 1659384774 · Nuclear Imaging & Therapy Physician · Philadelphia, PA
Provider details
- NPI number
- 1659384774
- Entity type
- Individual
- Primary specialty
- Nuclear Imaging & Therapy PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- MD031852L (PA)
Mailing address
111 Camelot Ln
Newtown Square, PA 19073-4412
Registry dates
- Enumerated
- 2006-08-14
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.