DR. TAE SUNG PARK (NPI# 1376560805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376560805 |
| Entity Type | Individual |
| Full Name | DR. TAE SUNG PARK |
| Credential | MD |
| Practice Address |
1 Childrens Pl Fl 1 1st Fl Saint Louis MO 63110-1002 |
| Mailing Address |
660 S Euclid Ave C B 8057 Saint Louis MO 63110-1010 |
| Practice Telephone | 3144542810 |
| Practice Fax Number | 3144542818 |
| Mailing Telephone | 3144542810 |
| Mailing Fax Number | 3144542818 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | R2K86 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ENROLLED | 05 | |
| MO | 202763108 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710273156 | Tae Sook Park | Acupuncturist | 903 S. Crenshaw Blvd, 302, Los Angeles, CA 90019 | 2011-06-23 |
| 1790870996 | Tae H Park | Dentist | 1875 E Alluvial Ave, Suite 102, Fresno, CA 93720-3856 | 2006-10-04 |
| 1336230259 | Tae K Park | Internal Medicine | 724 8th Ave, Brooklyn, NY 11215-4204 | 2006-09-27 |
| 1346297660 | Tae J. Park | Internal Medicine | 512 W Rosedale St, Fort Worth, TX 76104-4619 | 2006-05-30 |
| 1538133020 | Tae Won Park | Psychiatry & Neurology | 1547 S Wayne Rd, Westland, MI 48186 | 2006-02-14 |
| 1275015364 | Tae Park | Pharmacist | 1640 Hopkins Rd, Williamsville, NY 14221-1752 | 2018-09-05 |
| 1669751772 | Tae E Park | Pharmacist | 230 Park Ave, M-sp1-01, Florham Park, NJ 07901 | 2011-08-05 |
| 1093940249 | Tae Keun Park | Emergency Medicine | 300 Community Dr, Department of Emergency Medicine, Manhasset, NY 11030-3816 | 2009-05-18 |
| 1043308984 | Tae Park | Pharmacist | 1450 Chapel St, Pharmacy Department, New Haven, CT 06511-4405 | 2006-10-10 |
| 1932141942 | Tae Park | Radiology | University Hospital L2, Stony Brook, NY 11794-0001 | 2006-06-12 |
| Street Address |
1 CHILDRENS PL FL 1 1ST FL |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912276486 | Paul Edward Stohr | Neurological Surgery | 2 Kirken Knoll Dr, Saint Louis, MO 63131-2310 | 2011-12-29 |
| 1275801896 | George Emanuel Mendelsohn | Neurological Surgery | 24 Loren Woods, Saint Louis, MO 63124-1903 | 2011-12-09 |
| 1770802076 | Aneela Darbar | Neurological Surgery | 3635 Vista Ave, Grand Blvd, Saint Louis, MO 63110-0250 | 2010-05-26 |
| 1386850881 | David D Limbrick Jr. | Neurological Surgery | 1 Childrens Pl Ste 4e, Ste 4e, Saint Louis, MO 63110-1002 | 2007-05-14 |
| 1841218278 | Matthew D Smyth | Neurological Surgery | 1 Childrens Pl Ste 4s20, Ste 4s20, Saint Louis, MO 63110-1002 | 2006-07-17 |
| 1265420269 | Robert J Bernardi IIi | Neurological Surgery | 11605 Studt Ave, Suite One, Saint Louis, MO 63141-7052 | 2005-10-12 |
| 1457351926 | Gregory Joseph Bailey | Neurological Surgery | 1035 Bellevue Ave Ste 500, Saint Louis, MO 63117-1843 | 2005-07-27 |
| 1326048935 | Charles A Wetherington | Neurological Surgery | 6725 Chippewa St, Saint Louis, MO 63109-2534 | 2005-07-26 |
| 1306846928 | Armond L Levy | Neurological Surgery | 13625 Big Bend Rd, Saint Louis, MO 63122-3915 | 2005-07-26 |
| 1972500981 | Joseph S Yazdi | Neurological Surgery | 7721 Clayton Rd, Saint Louis, MO 63117-1301 | 2005-07-05 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
Please comment or provide details below to improve the information on DR. TAE SUNG PARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.