# DR SADTHA SURATTANONT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982818332
- **Authorized official:** DR. SADTHA SURATTANONT MD (DOCTOR)
- **Authorized official phone:** (304) 822-4241

## Contact information

- **Practice address:** 55 NORTH BOLTON ST, ROMNEY, WV 26757-1980
- **Practice address phone:** (304) 822-4241
- **Practice address fax:** (304) 822-3344
- **Mailing address:** PO BOX 1980, 55 NORTH BOLTON ST, ROMNEY, WV 26757-1980
- **Mailing address phone:** (303) 822-4241
- **Mailing address fax:** (304) 822-3344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 10426 | WV | Yes |

## Other

- **Enumeration date:** 05/09/2007
- **Last updated:** 06/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001720280 | BCBS | WV |
| 05 | — | 0127798000 | — | WV |
| 01 | — | 550623785 | ACORDIA PEIA | — |