Individual
TANYA AM NANONGKHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3310 MAGNOLIA ST, ORANGEBURG, SC 29115-1468
(803) 531-6900
(803) 531-6907
Mailing address
3310 MAGNOLIA ST, ORANGEBURG, SC 29115-1466
(803) 531-6900
(803) 531-6907
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
90003
SC
208000000X
Pediatrics Physician
MD61446233
WA
Other
Enumeration date
04/02/2020
Last updated
08/14/2023
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