Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 36107409 | IL |
NPI | 1144209966 |
---|---|
Provider Name | Dr. Manop Pithukpakorn |
First Address | Silver Spring, MD 20910-3054 |
Second Address | Bethesda, MD 20892-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 08/07/2007 |