Individual
DR. BOONYONG P THADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5356 REISTERSTOWN ROAD, BALTIMORE, MD 21215-4493
(410) 358-5111
(410) 358-9169
Mailing address
5356 REISTERSTOWN ROAD, BALTIMORE, MD 21215-4493
(410) 358-5111
(410) 358-9169
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0019823
MD
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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