Dr. Miracle Wangsuwana, D.O.
Psychiatry & Neurology, Neurology in North Las Vegas, NV. Individual provider (NPI-1).
NPI number1750377693
StatusActive
Last updated in NPPESMay 28, 2024
Details
- NPI
- 1750377693
- Entity type
- Individual (NPI-1)
- Name
- Dr. Miracle Wangsuwana
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 26, 2005
- Certification date
- Apr 18, 2022
- Last updated
- May 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | 1253 | NV | Yes |
Practice location
6900 North Pecos Road2nd Floor West Side 2b152 Va Southern Nevada
North Las Vegas, NV 89086
Phone 702-791-9161 · Fax 702-671-5891
Mailing address
6900 North Pecos Road2nd Floor West Side 2b 152 Va Southern Nevada
North Las Vegas, NV 89086
Phone 702-791-9161 · Fax 702-895-4014
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