Individual
SOMNUK POW-ANPONGKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1101 OCILLA RD, DOUGLAS, GA 31533-2207
(912) 384-1900
Mailing address
1101 OCILLA RD, DOUGLAS, GA 31533-2207
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
029756
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00344748B
—
GA
01
—
029756
STATE LICENSE
GA
Enumeration date
08/31/2005
Last updated
07/09/2007
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