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General NPI Number Information
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NPI Number | 1730356619
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Entity Type | Individual
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Provider Name | PHETPAILIN AMARALIKIT MD
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Gender | Female
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Dates
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Enumeration Date | 05/10/2008
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 420 ELDEN ST
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City | HERNDON
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State | VA
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Zip | 20170-4511
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Country | US
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Telephone | 571-353-1899
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Fax | 888-974-1477
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Provider Business Mailing Address
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Address Line | 420 ELDEN ST
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City | HERNDON
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State | VA
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Zip | 20170-4511
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Country | US
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Telephone | 571-353-1899
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Fax | 888-974-1477
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101244099
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License Number State | VA
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