# TANYANAN TANAWUTTIWAT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1992980767
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | 01083239A | IN | — |
| 207RC0000X | Cardiovascular Disease Physician | 23750 | MS | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | 01083239A | IN | Yes |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | 312475 | PA | — |

## Other

- **Enumeration date:** 12/29/2007
- **Last updated:** 07/26/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01083239A | LICENSE | IN |
| 05 | — | 07278029 | — | MS |
| 01 | — | P01590534 | RAILROAD MEDICARE | MS |