Individual
SUPHICHAYA MUANGMAN
Active
Individual
SUPHICHAYA MUANGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
043440
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001153600
—
CT
05
—
001434406
—
CT
01
—
010043440CT02
ANTHEM BCBS CT
CT
01
—
043440
CONNECTICARE
CT
01
—
1105253
USA
CT
01
—
25-33213
AMERICHOICE
CT
01
—
3V0829
HEALTHNET/COMMERCIAL
CT
01
—
518685
WELLCARE
CT
01
—
7085716
AETNA
CT
01
—
P00796456
RR MEDICARE
CT
01
—
P3941581
OXFORD
CT
Enumeration date
12/05/2006
Last updated
07/15/2014
Update your record
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