Individual
CHOCKEO SYVANTHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 MANNING DR, 1107G W WING, CHAPEL HILL, NC 27514-4220
(919) 423-5264
Mailing address
1 VAUXHALL PL, CHAPEL HILL, NC 27517-8615
(919) 423-5264
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101251595
VA
2085R0202X
Diagnostic Radiology Physician
060197
GA
2085R0202X
Diagnostic Radiology Physician
Primary
2011-00238
NC
Other
Enumeration date
12/29/2006
Last updated
05/17/2012
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