Individual
PONGCHAYUT SURAPIPITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-1000
(810) 342-1590
Mailing address
3200 BEECHER RD, FLINT, MI 48503-4968
(810) 342-5500
(810) 342-5545
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301044139
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202510851
BLUE CROSS BLUE SHIELD
MI
01
—
1008625
HEALTH ADVANTAGE
MI
05
—
4525121
—
MI
05
—
4735595
—
MI
01
—
A78286
HEALTH NET FEDERAL SERVIC
MI
Enumeration date
03/28/2006
Last updated
07/08/2007
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