Shalom Eastern Medicine,Inc

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

SHALOM EASTERN MEDICINE,INC

Practice address

3344 Saint Johns LN
Ellicott City, MD 21042-2601

Phone

(301) 814-1211

Fax

(240) 720-4900

NPI assigned

Aug 3, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Soon S. Park, OMDNPI 1437623725

Title

Owner

Phone

(301) 814-1211

Specialties & licenses 1

Addresses

Other names 1

• Shalom Acupuncture & Wellness Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Soon Sik Park

  • Acupuncturist
  • Ellicott City, MD
  • NPI 1437623725
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1366052664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3344 SAINT JOHNS LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422601",
            "telephone_number": "301-814-1211",
            "fax_number": "240-720-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3344 SAINT JOHNS LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422601",
            "telephone_number": "301-814-1211",
            "fax_number": "240-720-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM EASTERN MEDICINE,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SOON",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-814-1211",
        "authorized_official_credential": "OMD"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shalom Acupuncture & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Acupuncturist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Acupuncturist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.