Individual
DR. SUWARAT WONGJITTRAPORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
129 N WASHINGTON ST, SUMTER, SC 29150-4949
(803) 771-1788
(803) 774-9113
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7303
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M-2059
GU
208M00000X
Hospitalist Physician
36659
SC
208M00000X
Hospitalist Physician
Primary
M-2059
GU
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366598
—
SC
01
—
SC3808
MEDICARE
SC
Enumeration date
06/23/2011
Last updated
07/31/2017
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