Suphavejkornkij, Chanarong
Suphavejkornkij, Chanarong is an sole proprietor health care provider with primary practice located at 5 Woodvalley Ct , Reisterstown MD 21136-4629. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Suphavejkornkij, Chanarong can be contacted via phone (443) 881-4777.Contact Information
Primary practice address
5 Woodvalley Ct
Reisterstown MD 21136-4629
Phone: (443) 881-4777
Fax: (443) 881-4739
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | D0018970 | Maryland |
Profile Details
| NPI number | 1396758371 |
|---|---|
| LBN Legal business name | Suphavejkornkij, Chanarong |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 14th, 2006 |
| Last updated | Mar 21st, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396758371 | NPPES |
| Maryland | MEDICAID | 790611100 |
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