Individual
DARARAT MINGBUNJERDSUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3691
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
35-093581
OH
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
A92768
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A869820
MEDICARE
CA
05
—
00A869820
—
CA
05
—
1025735520001
—
PA
01
—
113678
UPIN
CA
05
—
2995540
—
OH
Enumeration date
11/08/2007
Last updated
05/16/2011
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