Organization
BACKPACK MEDICAL GROUP, P.C.
Active
Organization
BACKPACK MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUKE RUKTANONCHAI MD (PRESIDENT/OWNER)
(630) 306-4394
Entity
Organization
Contact information
Practice address
6655 SANTA BARBARA RD UNIT 8574, ELKRIDGE, MD 21075-7523
(866) 968-6342
(855) 615-2876
Mailing address
6655 SANTA BARBARA RD UNIT 8574, ELKRIDGE, MD 21075-7523
(630) 306-4394
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
09/07/2023
Last updated
08/05/2025
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