IndividualActive
Chanika Phornphutkul, MD
NPI 1639124530 · Clinical Biochemical Genetics Physician · Providence, RI
Provider details
- NPI number
- 1639124530
- Entity type
- Individual
- Primary specialty
- Clinical Biochemical Genetics PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- 10121 (RI)
Practice location
593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-8361
Fax: (401) 444-3288
Mailing address
593 Eddy St
Providence, RI 02903-4923
Registry dates
- Enumerated
- 2006-05-23
- Last updated
- 2011-12-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.