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Organization
MONGKOL MONG, M.D.P.C.
Active
Organization
MONGKOL MONG, M.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONGKOL MONGKOLPRADIT M.D. (PRESIDENT)
(734) 285-2255
Entity
Organization
Contact information
Practice address
15332 FORT ST, SOUTHGATE, MI 48195-1304
(734) 285-2255
(734) 285-9044
Mailing address
15332 FORT ST, SOUTHGATE, MI 48195-1304
(734) 285-2255
(734) 285-9044
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MM032063
MI
Other
Enumeration date
03/12/2007
Last updated
08/22/2020
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