Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ALISA THAVIKULWAT
Active Sole ProprietorOphthalmology · GLENN DALE, MD
Registration Details
- NPI Number
- 1265827745
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 1, 2015 (11.105797057031 yrs)
- Last Updated
- Sep 24, 2020
- License
-
D0087217 (MD)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12150 ANNAPOLIS RD STE 111GLENN DALE, MD, 207699183Browse MD providers · Browse ZIP 20769
- Phone
- 3017790844
- Primary Specialty
-
Ophthalmology
207W00000X
Other Ophthalmology Providers in GLENN DALE, MD
| Name | Credential | NPI |
|---|---|---|
| RENEE C BOVELLE | M.D. | 1588732424 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.