| Doctor Name: | THONGDANG BANCHUIN |
| NPI Number: | 1447357694 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 0101029458 |
| Business Practice Address: | 280 Virginia Ave Ne Suite 102 Norton, VA - 242731538 |
| Business Phone Number: | 2766790818 |
| Business Fax Number: | 2766790817 |
| Mailing Address: | 999 Executive Park Blvd, Suite 201 KINGSPORT |
| State: | TN |
| Postal Code: | 376604632 |
| Phone Number: | 4232243250 |
| Fax Number: | 4232243258 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 07/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101029458 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |