| Chotchai Boonkham MD PC | |
|
3478 Bridgeland Dr Suite 1 Bridgeton MO 63044-2619 | |
| (314) 291-3717 | |
| (314) 291-1671 |
| Full Name | Chotchai Boonkham MD PC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3478 Bridgeland Dr, Bridgeton, Missouri |
| Authorized Official Name and Position | Chotchai Boonkham (OWNER) |
| Authorized Official Contact | 3142913717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chotchai Boonkham MD PC 3478 Bridgeland Dr Suite 1 Bridgeton MO 63044-2619 Ph: (314) 291-3717 | Chotchai Boonkham MD PC 3478 Bridgeland Dr Suite 1 Bridgeton MO 63044-2619 Ph: (314) 291-3717 |
| NPI Number | 1619248853 |
|---|---|
| Provider Enumeration Date | 01/19/2012 |
| Last Update Date | 01/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619248853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 34210 (Missouri) | Primary |
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