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1538111356

NPI Code Detail

MEDICARE: THANAI PONGDEE MD

MEDICARE: THANAI PONGDEE MD

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	207K00000X	Allergy & Immunology Physician	L6579	TX
2	207K00000X	Allergy & Immunology Physician	ME107649	FL
3	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	L6579	TX
4	2080P0201X	Pediatric Allergy/Immunology Physician	L6579	TX
5	207K00000X	Allergy & Immunology Physician	44060	MN

General Provider Information

NPI Number	:	1538111356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THANAI PONGDEE MD

Provider Business Mailing Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0001
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0001
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	08/19/2020

Similar Medicare Providers

1679550206 — MARTHA FERNE HARTZ M.D.
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200 1ST ST SW
ROCHESTER, MN
55905-0001

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1366429573 — JOHN B HAGAN M.D.
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1982681136 — JOSEPH H BUTTERFIELD M.D.
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1619955739 — JAMES R MUNIS M.D.
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200 1ST ST SW
ROCHESTER, MN
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1154300861 — JAMES TUNG-CHIEH LI M.D.
Practice Location Address:

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ROCHESTER, MN
55905-0001

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1326028812 — GERALD W VOLCHECK M.D.
Practice Location Address:

200 1ST ST SW
ROCHESTER, MN
55905-0001

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1619940483 — MIGUEL (MICHAEL) A PARK M.D.
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55905-0001

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Practice Fax:

Directions to “ THANAI PONGDEE MD” Practice Location

Language	Start Address	Practice Location

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