Individual
DR. CHAIYOS KHONGKHATITHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5323 HARRY HINES BLVD, UT SOUTHWESTERN MEDICAL CENTER, DIV. OF PEDIATRIC NEURO, DALLAS, TX 75390-7201
(214) 456-8242
Mailing address
12000 FAIRHILL RD, APT. G1, CLEVELAND, OH 44120-1035
(216) 466-3510
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
57012391
OH
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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