MEDICARE: SOMSAK THIPLUEPORN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD427716	PA

General Provider Information

NPI Number	:	1740371483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOMSAK THIPLUEPORN MD

Provider Business Mailing Address
First Line	:	118 S ANDERSON ST STE 1
Second Line	:
City	:	BEDFORD
State	:	PA
Zip	:	15522-1403
Country	:	US
Telephone Number	:	814-623-2146
Fax Number	:	814-623-9469

Provider Business Practice Location Address
First Line	:	118 S ANDERSON ST STE 1
Second Line	:
City	:	BEDFORD
State	:	PA
Zip	:	15522-1403
Country	:	US
Telephone Number	:	814-623-2146
Fax Number	:	814-623-9469

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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