Provider Demographics
NPI:1033114996
Name:VONGKOVIT, PIYAPONG (MD)
Entity Type:Individual
Prefix:DR
First Name:PIYAPONG
Middle Name:
Last Name:VONGKOVIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7811 FOX GATE CT
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-4100
Mailing Address - Country:US
Mailing Address - Phone:202-346-3700
Mailing Address - Fax:202-346-3702
Practice Address - Street 1:700 2ND ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-8100
Practice Address - Country:US
Practice Address - Phone:202-346-3700
Practice Address - Fax:202-346-3702
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244938207RH0003X
MDD68503207RH0003X
DCMD038146207RH0003X
NC36611207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC85112OtherBLUE CROSS
NC8985112Medicaid
NC8985112Medicaid
NC2240426Medicare PIN