Individual
ATIP CHATSUDTHIPONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
207 QUAKER LN FL 1, WEST WARWICK, RI 02893-2179
(401) 828-7110
(401) 827-6364
Mailing address
2160 COLONIAL BLVD, FORT MYERS, FL 33907-1410
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD16055
RI
Other
Enumeration date
05/23/2012
Last updated
12/11/2020
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