Individual
PICHAYA SARASOMBATH RATARASARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3051 CAHILL MAIN, FITCHBURG, WI 53711-7109
(608) 661-7200
Mailing address
3700 PARMENTER ST APT 205, MIDDLETON, WI 53562-1537
(414) 243-2999
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
48712-020
WI
Other
Enumeration date
05/01/2006
Last updated
04/11/2017
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