Individual
DR. SOMPHONG THITARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2550 WINDY HILL RD SE, 106, MARIETTA, GA 30067-8665
(770) 955-4314
(770) 955-4315
Mailing address
2550 WINDY HILL RD SE, 106, MARIETTA, GA 30067-8665
(770) 955-4314
(770) 955-4315
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
15046
GA
Other
Enumeration date
09/28/2006
Last updated
07/09/2007
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