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Individual

DR. THAVIJ DAVID BURAPAVONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
416 GATEWOOD AVE, HIGH POINT, NC 27262-4718
(336) 882-2531
(336) 884-8254
Mailing address
416 GATEWOOD AVE, HIGH POINT, NC 27262-4718
(336) 882-2531
(336) 884-8254

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07194
BLUE CROSS BLUE SHIELD
NC
01
1310041
UNITED HEALTHCARE
NC
01
5987957-001
CIGNA HEALTHCARE
NC
05
7901794
NC
Enumeration date
04/20/2006
Last updated
06/30/2011
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