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Chotchai Boonkham Md Pc
Primary Care Clinic/Center in Bridgeton, Missouri
NPI 1619248853

Chotchai Boonkham Md Pc is a Primary Care Clinic/Center based in Bridgeton, MO and is specialized in Primary Care. Chotchai Boonkham Md Pc practices in Bridgeton, MO. The NPI Number for Chotchai Boonkham Md Pc is 1619248853 and holds a License No. 34210 (Missouri).

The current practice location address for Chotchai Boonkham Md Pc is 3478 Bridgeland Dr, Bridgeton, MO and can be reached out via phone at 314-291-3717 and via fax at 314-291-1671.

Location: 3478 Bridgeland Dr, Bridgeton, MO, 63044-2619
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1619248853
Provider Name
Chotchai Boonkham Md Pc
Credential
Provider Entity Type
Organization
Address
3478 Bridgeland Dr, Bridgeton, MO, 63044-2619
Phone Number
314-291-3717
Fax Number
314-291-1671
Provider Enumeration Date
01/19/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3478 Bridgeland Dr
City
Bridgeton
State
Missouri
Zip
63044-2619
Phone Number
314-291-3717
Fax Number
314-291-1671
person
Provider Business Mailing Address Details
Address
3478 Bridgeland Dr
City
Bridgeton
State
Missouri
Zip
63044-2619
Phone Number
314-291-3717
Fax Number
314-291-1671
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
34210 (Missouri)
Definition
Definition to come...
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