Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D0018850 | MD |
NPI | 1053496752 |
---|---|
Provider Name | Dr. Nibondh Chaiyupatumpa |
First Address | Baltimore, MD 21228-2527 |
Second Address | Baltimore, MD 21230-2333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B69976 | (02) | MD |