Individual
PANYAMOL PAM KITTIPONGDAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
500 EVERGREEN DR STE 20, GLEN MILLS, PA 19342-1032
(484) 785-3376
Mailing address
500 EVERGREEN DR STE 20, GLEN MILLS, PA 19342-1032
(484) 785-3376
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS018946
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103374660-0001
—
PA
Enumeration date
11/04/2013
Last updated
08/08/2026
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