Individual
SAOWANEE NGAMRUENGPHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4940 EASTERN AVE, A BUILDING, 5TH FLOOR, BALTIMORE, MD 21224-2735
(410) 550-1793
(410) 550-7861
Mailing address
4940 EASTERN AVE, A BUILDING, 5TH FLOOR, BALTIMORE, MD 21224-2735
(410) 550-1793
(410) 550-7861
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME109387
FL
207RG0100X
Gastroenterology Physician
Primary
D81862
MD
390200000X
Student in an Organized Health Care Education/Training Program
BP10032775
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003733500
—
FL
05
—
113054400
—
MD
Enumeration date
07/10/2008
Last updated
03/13/2017
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