Individual
CHANHSAMONE SYRAVANH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4745 OGLETOWN STANTON RD, MEDICAL ARTS PAVILION 1, SUITE 135, HOSMANE CARDIOLOGY, NEWARK, DE 19713-2067
(302) 292-3541
(302) 292-3542
Mailing address
4745 OGLETOWN STANTON RD, MEDICAL ARTS PAVILION 1, SUITE 135, HOSMANE CARDIOLOGY, NEWARK, DE 19713-2067
(302) 292-3541
(302) 292-3542
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C5-0000559
DE
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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