Individual
TANYA AM NANONGKHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 KING ST, CHARLESTON, SC 29403-3708
(843) 985-4473
Mailing address
125 DOUGHTY ST STE 530, MSC 917, CHARLESTON, SC 29403-5744
(843) 792-0269
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
06/16/2026
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