Healthcare Provider Details

I. General information

NPI: 1922311026
Provider Name (Legal Business Name): PARIT MEKAROONKAMOL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE
ATLANTA GA
30322-2601
US

IV. Provider business mailing address

8460 LIMEKILN PIKE APT1102
WYNCOTE PA
19095-2601
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-3184
  • Fax:
Mailing address:
  • Phone: 215-820-9308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number6362
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: