Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 0101244938 | VA |
Y | 207RH0003X | Hematology & Oncology | 36611 | NC |
N | 207RH0003X | Hematology & Oncology | D68503 | MD |
N | 207RH0003X | Hematology & Oncology | MD038146 | DC |
NPI | 1033114996 |
---|---|
Provider Name | Dr. Piyapong Vongkovit |
First Address | Bethesda, MD 20817-4100 |
Second Address | Washington, DC 20002-8100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 28/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
85112 | BLUE CROSS (01) | NC |
8985112 | (05) | NC |
F19513 | (02) | NC |