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Individual

DR. TEERATH PETER TANPITUKPONGSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3200 BLUE RIDGE RD STE 100, RALEIGH, NC 27612-8087
(919) 781-1437
(919) 787-4870
Mailing address
1121 SITUS CT, STE 170, RALEIGH, NC 27606-4279
(919) 834-2767
(919) 834-0234

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
2012-02013
NC
2085R0202X
Diagnostic Radiology Physician
0101270926
VA
2085R0202X
Diagnostic Radiology Physician
Primary
2012-02013
NC

Other

Enumeration date
05/10/2012
Last updated
04/27/2023
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