Individual
PEYAPONG PATANAPHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 E 33RD ST, SUITE 631, BALTIMORE, MD 21218-3322
(410) 532-4848
(410) 554-4455
Mailing address
1 ROLAND CT, RUXTON, MD 21204-3550
(410) 337-8805
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
D21797
MD
207Y00000X
Otolaryngology Physician
Primary
D0021797
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
979801300
—
MD
Enumeration date
11/13/2006
Last updated
04/13/2016
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