Provider Demographics
NPI:1235748062
Name:DO, SON THAI (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SON
Middle Name:THAI
Last Name:DO
Suffix:
Gender:M
Credentials:PA-C
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Other - Last Name:
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Mailing Address - Street 1:51 MEMORIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4505
Mailing Address - Country:US
Mailing Address - Phone:617-838-8258
Mailing Address - Fax:
Practice Address - Street 1:51 MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4505
Practice Address - Country:US
Practice Address - Phone:617-838-8258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant