Thongteum, Boonpon

Thongteum, Boonpon is an individual health care provider with primary practice located at 186 Kimel Park Dr , Winston-Salem NC 27103-6946. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Thongteum, Boonpon can be contacted via phone (336) 277-2000.

Contact Information

Primary practice address
186 Kimel Park Dr Winston-Salem NC 27103-6946
Phone: (336) 277-2000
Fax: (336) 277-2050
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 900419 North Carolina

Profile Details

NPI number 1255392536
LBN Legal business name Thongteum, Boonpon
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Oct 28th, 2020 - about 4 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1255392536 NPPES
North Carolina MEDICAID 7005137
North Carolina Other 1285682310

Popular Providers