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Individual

DR. PONGSTORN PITIRANGGON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
514 S DARGAN ST, SUITE H, FLORENCE, SC 29506-2552
(843) 669-5956
(843) 669-2019
Mailing address
514 S DARGAN ST, SUITE H, FLORENCE, SC 29506-2552
(843) 669-5956
(843) 669-2019

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20141
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
T42219
SC
Enumeration date
08/19/2005
Last updated
01/05/2012
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