Provider Demographics
NPI:1326004417
Name:APIBUNYOPAS, CHARUROPE CHOUVALIT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARUROPE
Middle Name:CHOUVALIT
Last Name:APIBUNYOPAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:A
Other - Middle Name:C
Other - Last Name:CHOUVALIT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9125 BELAIR ROAD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236
Mailing Address - Country:US
Mailing Address - Phone:410-256-9401
Mailing Address - Fax:410-256-3852
Practice Address - Street 1:9125 BELAIR ROAD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:410-256-9401
Practice Address - Fax:410-256-3852
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0016306207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD357611601Medicaid
MD2469Medicare ID - Type Unspecified
MD357611601Medicaid