DR. Nutaporn Sukontasup, OD

NPI #1104930817 in Fulton, Maryland

Provider Information

NPI Number: 1104930817
Entity Type: Individual
Name: DR. Nutaporn Sukontasup, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Aug 18, 2006
Last Updated: Jan 15, 2017

Practice Location

Address: 8115 MAPLE LAWN BLVD
Address 2: SUITE 135
City: Fulton
State: Maryland
ZIP Code: 20759-2681
Phone: (443) 804-1173

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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