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Individual

SIRIDAO LAOHASATIT CHENG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10939 AL HIGHWAY 157, MOULTON, AL 35650-1900
(256) 974-3390
(256) 905-0261
Mailing address
PO BOX 340, MOULTON, AL 35650-0340
(256) 974-3390
(256) 905-0261

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
00020658
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
540003401
AL
05
540003994
AL
Enumeration date
06/21/2006
Last updated
05/16/2008
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