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1063504074
SOMPHONG THITARAM
MARIETTA, GA
NPI
1063504074
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208D00000X General Practice
(Licence: GA 15046)
Enumeration Date
2006-09-28
Last Update Date
2007-07-09
Business Address
Dr. SOMPHONG THITARAM MD
2550 WINDY HILL RD SE 106
MARIETTA, GA 30067-8665
Phone number: 770-955-4314
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Mailing Address
Dr. SOMPHONG THITARAM MD
2550 WINDY HILL RD SE 106
MARIETTA, GA 30067-8665
Phone number: 770-955-4314
Copy
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