Stephen Joseph Park (NPI# 1649407289, PAC ID# 2860793874) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GASTROENTEROLOGY.
| Nation Provider ID (NPI) | 1649407289 |
| PAC ID by PECOS | 2860793874 |
| Professional Enrollment ID | I20190730000131 |
| Full Name | Stephen Joseph Park |
| Organization Legal Name | CAPITAL DIGESTIVE CARE LLC |
| Address |
3280 Urbana Pike Suite 101 Ijamsville MD 21754-9411 |
| Phone Number | 3018105252 |
| Gender | M |
| Graduation Year | 2009 |
| Primary Specialty | GASTROENTEROLOGY |
| Group Practice PAC ID | 3870669419 |
| Number of Group Practice Members | 80 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210057 | ADVENTIST HEALTHCARE SHADY GROVE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 400 W 7th St, Frederick, MD 21701-4506 | 2405663300 | CAPITAL DIGESTIVE CARE LLC |
| 3280 Urbana Pike, Suite 101, Ijamsville, MD 21754-9411 | 3018105252 | CAPITAL DIGESTIVE CARE LLC |
| 3280 Urbana Pike, Suite 204, Ijamsville, MD 21754-9406 | 3018105252 | CAPITAL DIGESTIVE CARE LLC |
| 14955 Shady Grove Rd, Suite 150, Rockville, MD 20850-8725 | 3013403252 | CAPITAL DIGESTIVE CARE LLC |
| 9711 Medical Ctr Dr, Suite 308, Rockville, MD 20850-3388 | 3012511244 | CAPITAL DIGESTIVE CARE LLC |
| 2021 K St Nw, Suite T 110, Washington, DC 20061-1036 | 2022963449 | CAPITAL DIGESTIVE CARE LLC |
| Organization Legal Name | CAPITAL DIGESTIVE CARE LLC |
| Physicians | 90 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Zhengtong Pei | Pathology | Capital Digestive Care LLC | 4831 Telsa Dr F, Bowie, MD 20715-4328 |
| Jennifer Lang | Nurse Practitioner | Capital Digestive Care LLC | 5550 Friendship Blvd, T90, Chevy Chase, MD 20815-7313 |
| Lawrence A Bassin | Gastroenterology | Capital Digestive Care LLC | 14955 Shady Grove Rd, Suite 150, Rockville, MD 20850-8725 |
| Kelly A Mercado | Nurse Practitioner | Capital Digestive Care LLC | 2021 K St Nw, Suite T 110, Washington, DC 20061-1036 |
| Roderick B Kreisberg | Gastroenterology | Capital Digestive Care LLC | 2021 K St Nw, Suite T 110, Washington, DC 20061-1036 |
| Michael J Schwartz | Gastroenterology | Capital Digestive Care LLC | 2021 K St Nw, Suite T 110, Washington, DC 20061-1036 |
| Dominique E Howard | Gastroenterology | Capital Digestive Care LLC | 2021 K St Nw, Suite T 110, Washington, DC 20061-1036 |
| George Bolen | Gastroenterology | Capital Digestive Care LLC | 2021 K St Nw, Suite T 110, Washington, DC 20061-1036 |
| Amy G. Shah | Gastroenterology | Capital Digestive Care LLC | 5550 Friendship Blvd, T90, Chevy Chase, MD 20815-7313 |
| Jonathan Koff | Gastroenterology | Capital Digestive Care LLC | 2021 K St Nw, Suite T 110, Washington, DC 20061-1036 |
| Street Address |
3280 URBANA PIKE SUITE 101 |
| City | IJAMSVILLE |
| State | MD |
| Zip | 21754-9411 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kaitlyn Martinaitis | Physical Therapy | Maryland Sportscare and Rehab LLC | 3280 Urbana Pike, Suite 202, Ijamsville, MD 21754-9406 |
| Krystyna Lapciuk | Certified Registered Nurse Anesthetist (crna) | 3280 Urbana Pike, Ijamsville, MD 21754-9406 | |
| Julie A Jurd | Podiatry | 3280 Urbana Pike, Suite 202, Ijamsville, MD 21754-9406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leah C Griswold | Chiropractic | 9639 Dr Perry Rd, Suite 103, Ijamsville, MD 21754-8728 |
| City | IJAMSVILLE |
| Zip Code | 21754 |
| Specialty | GASTROENTEROLOGY |
| City + Specialty | IJAMSVILLE + GASTROENTEROLOGY |
Please comment or provide details below to improve the information on Stephen Joseph Park.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.