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1255392536
BOONPON THONGTEUM
WINSTON-SALEM, NC
NPI
1255392536
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NC 900419)
Enumeration Date
2006-03-28
Last Update Date
2020-10-28
Business Address
BOONPON THONGTEUM NP
186 KIMEL PARK DR
WINSTON-SALEM, NC 27103-6946
Phone number: 336-277-2000
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Mailing Address
BOONPON THONGTEUM NP
PO BOX 751803
CHARLOTTE, NC 28275-1803
Phone number: 336-277-2000
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