Individual
AMY KIATTHANAPAIBOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
270 COPPERFIELD BLVD NE STE 201, CONCORD, NC 28025-2444
(704) 786-6521
(704) 782-9703
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 403-0470
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2025-02759
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2022
Last updated
08/22/2025
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