MEDICARE: MISS PATAMAPORN LEKPRASERT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	MD450926	PA

General Provider Information

NPI Number	:	1255560421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS PATAMAPORN LEKPRASERT M.D.

Provider Business Mailing Address
First Line	:	50 TOWNSHIP LINE RD
Second Line	:	MEDICAL ARTS BUILDING, SUITE G-01
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-2249
Country	:	US
Telephone Number	:	215-572-5200
Fax Number	:	215-572-6456

Provider Business Practice Location Address
First Line	:	50 TOWNSHIP LINE RD
Second Line	:	MEDICAL ARTS BUILDING, SUITE G01
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-2249
Country	:	US
Telephone Number	:	215-572-5200
Fax Number	:	215-572-6456

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2009
Last Update Date	:	02/02/2015

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