Individual
DR. CHONCHAROEN AMPHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6654
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4123
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23697
SC
207RN0300X
Nephrology Physician
23697
SC
208M00000X
Hospitalist Physician
23697
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23697-0
—
SC
Enumeration date
09/29/2006
Last updated
07/17/2024
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