| Somphong Thitaram Md | |
|
5555 Buford Hwy 501 Norcross GA 30071-3957 | |
| (770) 446-6655 | |
| (770) 446-6659 |
| Full Name | Somphong Thitaram Md |
|---|---|
| Speciality | General Practice |
| Location | 5555 Buford Hwy, Norcross, Georgia |
| Authorized Official Name and Position | Somphong Thitaram (PRESIDENT) |
| Authorized Official Contact | 7704466655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Somphong Thitaram Md 5555 Buford Hwy 501 Norcross GA 30071-3957 Ph: (770) 446-6655 | Somphong Thitaram Md 5555 Buford Hwy 501 Norcross GA 30071-3957 Ph: (770) 446-6655 |
| NPI Number | 1649359753 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649359753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 15046 (Georgia) | Primary |
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