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Deactivated NPI 1891778064 Deactivated / Inactive NPI Male Practitioner

Dr. Brian B Park , DC

Chiropractor • Baltimore, MD

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Brian Park has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 22, 2005
NPI Deactivation Date September 25, 2025
Total Practice Duration ~20 Years of Practice (2005 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Brian Park, DC was a registered Chiropractor practicing in Baltimore, MD. Throughout an active medical career spanning 20 years, Dr. Park provided care at the practice location at 4200 EDMONDSON AVE until profile deactivation on 2025-09-25.

Practice Location & Contact Primary Location

Practice Address

4200 Edmondson Ave
Suite 101

Baltimore, MD 212291612

Telephone 4109470300
Fax 4109470328
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Baltimore, MD

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.1 Yrs
State Avg: 24.5 Yrs
Regional Practice Density
114 Specialists

Practicing in Baltimore, MD (905 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License MD S01759

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1629076443

Doctor of Chiropractic

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 25, 2025

Record deactivated on September 25, 2025

NPI Profile Active July 01, 2015

NPI status registered as active in NPPES database

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Updated Practice Location July 01, 2015

Registered at 4200 EDMONDSON AVE, SUITE 101, BALTIMORE, MD 212291612 (Tel: 4109470300)

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Updated Business Mailing Address July 01, 2015

Registered at 9601 PULASKI PARK DR, SUITE 416, BALTIMORE, MD 212201409 (Tel: 4109335678)

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Provider Name / Credentials Updated July 01, 2015

Recorded as BRIAN PARK, DC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 01, 2015

Chiropractor (License #S01759 in MD)

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Initial NPI Registration & Enumeration November 22, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891778064
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 22, 2005
Last Update: July 01, 2015
Deactivation Date: September 25, 2025

Mailing Address

9601 Pulaski Park Dr, Suite 416

Baltimore, MD 212201409

Phone: 4109335678

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.