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Organization

DR SADTHA SURATTANONT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SADTHA SURATTANONT MD (DOCTOR)
(304) 822-4241
Entity
Organization

Contact information

Practice address
55 NORTH BOLTON ST, ROMNEY, WV 26757-1980
(304) 822-4241
(304) 822-3344
Mailing address
PO BOX 1980, 55 NORTH BOLTON ST, ROMNEY, WV 26757-1980
(303) 822-4241
(304) 822-3344

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
10426
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001720280
BCBS
WV
05
0127798000
WV
01
550623785
ACORDIA PEIA
Enumeration date
05/09/2007
Last updated
06/13/2008
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