Pattaraphongpan Chaiyamart
Registered Nurse, General Practice in Saint Paul, MN. Individual provider (NPI-1).
NPI number1043073133
StatusActive
Last updated in NPPESFeb 2, 2024
Details
- NPI
- 1043073133
- Entity type
- Individual (NPI-1)
- Name
- Pattaraphongpan Chaiyamart
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 1, 2024
- Certification date
- Feb 2, 2024
- Last updated
- Feb 2, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WG0000X | Registered Nurse, General Practice | 2489704 | MN | Yes |
Practice location
1048 Central Ave WSaint Paul, MN 55104-4728
Phone 612-239-8235
Mailing address
1048 Central Ave WSaint Paul, MN 55104-4728
Phone 612-239-8235
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