# MR. PRAKORB ISARIYAWONGSE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1912012022
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | MD033993L | PA | — |
| 208D00000X | General Practice Physician | MD033993L | PA | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 08/17/2011

## 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 |