Individual
DR. MONGKOL MONGKOLPRADIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15332 FORT ST, SOUTHGATE, MI 48195-1304
(734) 285-2255
Mailing address
15332 FORT ST, SOUTHGATE, MI 48195-1304
(734) 285-2255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MM032063
MI
Other
Enumeration date
08/27/2005
Last updated
07/09/2007
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