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Individual

WANWIWAT LOVICHIT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12500 WILLOWBROOK RD, CUMBERLAND, MD 21502-6393
(240) 964-7000
Mailing address
15401 WILLIAMS RD SE, CUMBERLAND, MD 21502-7975
(901) 462-7876

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0091763
MD
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/28/2017
Last updated
03/10/2022
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