Individual
MR. ANAWIN SANGUANKEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2730
(360) 414-2739
Mailing address
4101 N WATER TOWER PL, MOUNT VERNON, IL 62864-6296
(618) 244-4313
(410) 367-2258
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036147020
IL
207R00000X
Internal Medicine Physician
MD61239740
WA
207RN0300X
Nephrology Physician
036147020
IL
207RN0300X
Nephrology Physician
Primary
MD61239740
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2014
Last updated
07/21/2022
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