Supattapone, Surachai
Supattapone, Surachai is an individual health care provider with primary practice located at 1 Medical Center Dr , Lebanon NH 03756-1000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Supattapone, Surachai can be contacted via phone (603) 650-6060.Contact Information
Primary practice address
1 Medical Center Dr
Lebanon NH 03756-1000
Phone: (603) 650-6060
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 11491 | New Hampshire |
Profile Details
| NPI number | 1912911272 |
|---|---|
| LBN Legal business name | Supattapone, Surachai |
| Credentials | M.D., PH.D., D.PHIL. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 29th, 2006 |
| Last updated | Nov 26th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912911272 | NPPES |
| Vermont | MEDICAID | 1008585 | |
| Vermont | MEDICAID | 30202034 |
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