Individual
DR. PUANGPETCH CHANBUSARAKUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
722 WILLIAMSON ST, MADISON, WI 53703-3546
(608) 267-1445
Mailing address
5005 COTTAGE GROVE RD, MADISON, WI 53716-1309
(608) 267-1445
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21116
WI
Other
Enumeration date
04/09/2007
Last updated
07/10/2014
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