Individual
PHENPAN HIRUNYACHOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
MAUMENEE B 110 600N WOLFE ST, BALTIMORE, MD 21287-0001
(410) 955-6052
(410) 955-1985
Mailing address
3501 SAINT PAUL ST, BALTIMORE, MD 21218-2703
(443) 453-3634
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/01/2009
Last updated
09/01/2009
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