Pitiranggon, Pongstorn

Pitiranggon, Pongstorn is an individual health care provider with primary practice located at 514 S Dargan St Suite H, Florence SC 29506-2552. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Pitiranggon, Pongstorn can be contacted via phone (843) 669-5956.

Contact Information

Primary practice address
514 S Dargan St Suite H Florence SC 29506-2552
Fax: (843) 669-2019
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 20141 South Carolina

Profile Details

NPI number 1740272236
LBN Legal business name Pitiranggon, Pongstorn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Jan 5th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740272236 NPPES
South Carolina MEDICAID T42219

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