Individual
DR. VANEE WONGSURAWAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1860 GRASSY RIDGE RD, SAINT LOUIS, MO 63122-3536
(314) 966-6574
(314) 966-0323
Mailing address
1860 GRASSY RIDGE RD, SAINT LOUIS, MO 63122-3536
(314) 966-6574
(314) 966-0323
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R7A12
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202926408
—
MO
Enumeration date
08/16/2006
Last updated
07/08/2010
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