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Individual

DR. PHILIP JARATSAK NIVATPUMIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9114 PHILADELPHIA RD, SUITE 208, BALTIMORE, MD 21237-4317
(410) 687-5300
(410) 682-4418
Mailing address
9114 PHILADELPHIA RD, SUITE 208, BALTIMORE, MD 21237-4317
(410) 687-5300
(410) 682-4418

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
D0058475
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
401416200
MD
Enumeration date
05/25/2006
Last updated
06/01/2011
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