Individual
DR. THAVORN LORUNGROCHANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4649 NANNIE HELEN BURROUGHS AVE NE, WASHINGTON, DC 20019-3662
(202) 398-4700
(202) 398-4701
Mailing address
12025 APPLE KNOLL CT, NORTH POTOMAC, MD 20878-2374
(301) 840-9482
(301) 840-9482
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD7557
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2219400
AETNA HEALTHCARE
DC
01
—
274363
TRICARE
DC
01
—
3220-0001
BLUE CROSS BLUE SHIELD
DC
01
—
4053222
AETNA CHOICE
DC
Enumeration date
08/31/2006
Last updated
07/09/2007
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