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Individual
MR. PRAKORB ISARIYAWONGSE
Active
Individual
MR. PRAKORB ISARIYAWONGSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD033993L
PA
208D00000X
General Practice Physician
Primary
MD033993L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005869240004
—
PA
01
—
020031897
PALMETTO MEDICARE
—
01
—
0708585
UNITED MINE WORKERS
—
01
—
129649
HIGHMARK
PA
01
—
18700
HEALTH AMERICA
PA
01
—
202932
UPMC
PA
01
—
251310157
UNITED HEALTH CARE
—
01
—
60542
UNISON
—
01
—
7938474011
CIGNA
PA
Enumeration date
08/20/2006
Last updated
08/17/2011
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