Individual
DR. CHUTCHARN KONGPHANICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1044 ISLAND DRIVE CT APT 104, ANN ARBOR, MI 48105-2075
(734) 883-3181
Mailing address
1044 ISLAND DRIVE CT APT 104, ANN ARBOR, MI 48105-2075
(734) 883-3181
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
4301088636
MI
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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