Individual
HURSUONG VONGSACHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
243 CHARLES ST, BOSTON, MA 02114-3096
(617) 573-3966
Mailing address
243 CHARLES ST, BOSTON, MA 02114-3096
(617) 573-3966
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
293334
MA
Other
Enumeration date
12/03/2018
Last updated
07/06/2022
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