Individual
VINITA PATANAPHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 BRASS MILL RD, SUITE E, BELCAMP, MD 21017-1217
(410) 272-9224
(410) 575-7591
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
D21798
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01189076
AMERIGROUP
MD
01
—
1043770
CIGNA PROVIDER #
MD
05
—
154681300
—
MD
01
—
34578005
CARE FIRST BCBS PROV. #
MD
01
—
4421117
AETNA PROVIDER #
MD
01
—
5160
ELDER HEALTH PROVIDER #
MD
05
—
649911200
—
MD
01
—
6882-0002
CAREFIRST BCBS- DC
MD
Enumeration date
11/15/2005
Last updated
01/19/2009
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