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Individual

DR. AN NGOC THAI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD.

Contact information

Practice address
1443B DORCHESTER AVE, DORCHESTER, MA 02122-1347
(617) 265-0955
(617) 265-0086
Mailing address
16 GLEASON ST, WATERTOWN, MA 02472-1608
(617) 926-2193
(617) 265-0086

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50544
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6181287
MA
Enumeration date
01/10/2007
Last updated
07/09/2007
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