1326302761

Everything you always wanted to know about POOWANAWITTAYAKOM NONGNOOCH MD but were afraid to ask.

POOWANAWITTAYAKOM NONGNOOCH MD

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Provider Last Name Provider First Name Provider Credential
POOWANAWITTAYAKOM NONGNOOCH MD
Gender:
Female
Enumeration date:
2012-06-29
Last update date:
2017-09-01
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
Search for NONGNOOCH, POOWANAWITTAYAKOM in
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
207RI0200X Infectious Disease MA 270143 Y

Phone Numbers

Type Number
Practice Location Address Telephone Number 5085596699
Mailing Address Fax Number 5085595073
Practice Location Address Fax Number 5085595073
Mailing Address Telephone Number (508) 559-6699

Addresses

Type Address City State Postal Country
Mailing Address 63 MAIN STREET BROCKTON MA 2301 MA
Practice Location Address 63 MAIN STREET BROCKTON MA 2301 MA

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