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Individual
TANYANAN TANAWUTTIWAT
Active
Individual
TANYANAN TANAWUTTIWAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01083239A
IN
207RC0000X
Cardiovascular Disease Physician
23750
MS
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
01083239A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
312475
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01083239A
LICENSE
IN
05
—
07278029
—
MS
01
—
P01590534
RAILROAD MEDICARE
MS
Enumeration date
12/29/2007
Last updated
07/26/2025
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