Individual
PHUMPATTRA CHARIYAWONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4618
(207) 662-6254
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4618
(207) 662-6254
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD30158
ME
207R00000X
Internal Medicine Physician
T3600
TX
208M00000X
Hospitalist Physician
Primary
MD30158
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T3600
TEXAS MEDICAL BOARD
TX
Enumeration date
07/22/2015
Last updated
03/05/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us