Terry Supanee Chongulia M.D.

NPI 1992800742 - Legal Medicine - 173000000X

NPI Details
NPI 1992800742
Gender Female
Enumeration Date 09/14/2006
Last Updated 02/01/2016
Entity Type Individual
Active Over 10 years ago
Practice Location
513 GREAT OAKS DR STE A
MONROE GA, 30655-8211, US
Phone (770) 267-8368
Fax (770) 207-0640
Business Location
2370 HILLSIDE TRCE
MONROE GA, 30655-5880, US
Phone (770) 267-0085
Fax
Toxanomy
Taxonomy Code 173000000X
License State Georgia
License Number 053640
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According to our database, Terry Supanee Chongulia M.D. NPI is 1992800742, taxonomy code is 173000000X and license number is 053640, license state is located at Georgia. Terry Supanee Chongulia M.D. physically located at 513 Great Oaks Dr Ste A, Monroe GA, 30655-8211. NPI Number Terry Supanee Chongulia M.D. has the Individual type.

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1992800742 NPI number is provided on an as is basis without warranty of any kind. 1992800742 is maintained by the National Plan & Provider Enumeration System. The contents of Terry Supanee Chongulia M.D. are for informational purposes only.