ALISA THAVIKULWAT

GLENN DALE, MD
NPI1265827745
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207W00000X Ophthalmology
(Licence: MD  D0087217)
Enumeration Date2015-04-01
Last Update Date2020-09-24
Business Address
ALISA THAVIKULWAT
12150 ANNAPOLIS RD STE 111
GLENN DALE, MD 20769-9183
Phone number: 301-779-0844
Mailing Address
ALISA THAVIKULWAT
1855 W TAYLOR ST DEPARTMENT OF OPHTHALMOLOGY
CHICAGO, IL 60612-7242
Phone number:
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