MEDICARE: PIAMAS PUATRAKUL

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	183500000X	Pharmacist	17834	MD

General Provider Information

NPI Number	:	1376955732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIAMAS PUATRAKUL

Provider Business Mailing Address
First Line	:	10503 BRUNSWICK AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-4811
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10503 BRUNSWICK AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-4811
Country	:	US
Telephone Number	:	301-760-6924
Fax Number	:

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

Provider Enumeration Date	:	05/20/2014
Last Update Date	:	05/20/2014

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Directions to “ PIAMAS PUATRAKUL ” Practice Location

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