Individual
DULAYA KANJANA SANTIKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
275 E 200 S, SALT LAKE CITY, UT 84111-2002
(800) 366-1884
(801) 487-8197
Mailing address
71 GLEN RD, YONKERS, NY 10704-3617
(914) 882-9971
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3592
AK
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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