Mrs. Kingkhan Boriboon
Adolescent Medicine
3850 Pelham St
Dearborn
, Michigan 48124-3832
Mrs. Kingkhan Boriboon
Adolescent Medicine
3850 Pelham St
Dearborn
, Michigan 48124-3832
(313) 562-7567
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Mrs. Kingkhan Boriboon
- 3850 Pelham St
- Dearborn, MI
- Zip : 48124-3832
- Fax : (313) 562-7567
- Phone : (313) 562-9500
Second Address
- Mrs. Kingkhan Boriboon
- 3850 Pelham St
- Dearborn, MI
- Zip : 48124-3832
- Fax : (313) 562-7567
- Phone : (313) 562-9500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | 4301031543 | MI |
National Provider Identifier
| NPI | 1023103025 |
|---|---|
| Provider Name | Mrs. Kingkhan Boriboon |
| First Address | Dearborn, MI 48124-3832 |
| Second Address | Dearborn, MI 48124-3832 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| E37969 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.