Individual
DR. SURACHAI SUPATTAPONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D., D.PHIL.
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-6060
Mailing address
1 MEDICAL CENTER DR, DHMC, LEBANON, NH 03756-1000
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
11491
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008585
—
VT
05
—
30202034
—
NH
Enumeration date
07/29/2006
Last updated
11/26/2007
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