Individual
PONGWUT DANCHAIVIJITR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6565 N CHARLES ST, PPE SUITE 203, BALTIMORE, MD 21204-6800
(443) 849-2682
(443) 849-8030
Mailing address
6565 N CHARLES ST, PPE SUITE 203, BALTIMORE, MD 21204-6800
(443) 849-2682
(443) 849-8030
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
P24253
MD
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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