Individual
DR. CAROLYN DIANE THANGAWNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH, FASAM
Contact information
Practice address
BALTIMORE CENTRAL BOOKING & INTAKE, 300 EAST MADISON STREET, BALTIMORE, MD 21202-4260
(615) 660-7119
Mailing address
21416 DENIT ESTATES DR, BROOKEVILLE, MD 20833-1832
(860) 709-3334
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
D0087899
MD
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
MD464459
PA
2083P0901X
Public Health & General Preventive Medicine Physician
D0087899
MD
2083P0901X
Public Health & General Preventive Medicine Physician
MD464459
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103683924-000
—
PA
Enumeration date
06/23/2011
Last updated
03/23/2023
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