Individual
SUPATIDA TENGSUPAKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1601 CENTER ST, MOBILE, AL 36604-1541
(251) 410-5437
(251) 434-3852
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 434-3626
(251) 445-2464
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
P7581
TX
2080P0208X
Pediatric Infectious Diseases Physician
Primary
35632
AL
2080P0208X
Pediatric Infectious Diseases Physician
P7581
TX
Other
Enumeration date
04/29/2010
Last updated
03/03/2021
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