Doctor Name: | DR. THAVIJ DAVID BURAPAVONG |
NPI Number: | 1922063023 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 416 Gatewood Ave High Point, NC - 272624718 |
Business Phone Number: | 3368822531 |
Business Fax Number: | 3368848254 |
Mailing Address: | 416 Gatewood Ave, HIGH POINT |
State: | NC |
Postal Code: | 272624718 |
Phone Number: | 3368822531 |
Fax Number: | 3368848254 |
NPI Enumeration Date: | 04/20/2006 |
NPI Last Update Date: | 06/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |