Individual
DR. WISIT CHEUNGPASITPORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
24590
MS
207RN0300X
Nephrology Physician
Primary
56833
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08175863
—
MS
01
—
P01234124
RAILROAD MEDICARE
MN
Enumeration date
06/21/2010
Last updated
09/30/2020
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