Provider Demographics
NPI:1740371483
Name:THIPLUEPORN, SOMSAK (MD)
Entity type:Individual
Prefix:
First Name:SOMSAK
Middle Name:
Last Name:THIPLUEPORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S ANDERSON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522-1403
Mailing Address - Country:US
Mailing Address - Phone:814-623-2146
Mailing Address - Fax:814-623-9469
Practice Address - Street 1:118 S ANDERSON ST STE 1
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-1403
Practice Address - Country:US
Practice Address - Phone:814-623-2146
Practice Address - Fax:814-623-9469
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427716207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine