Organization
CHET PHITAYAKORN, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHET PHITAYAKORN M.D. (PRESIDENT)
(412) 469-7030
Entity
Organization
Contact information
Practice address
575 COAL VALLEY RD, SUITE 365, CLAIRTON, PA 15025-3730
(412) 469-7030
(412) 469-7160
Mailing address
575 COAL VALLEY RD, SUITE 365, CLAIRTON, PA 15025-3730
(412) 469-7030
(412) 469-7160
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD031414L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017555940001
—
PA
Enumeration date
07/22/2006
Last updated
08/22/2020
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