Individual
SAKKAPOL ONGWIJITWAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7930 N SHADELAND AVE, INDIANAPOLIS, IN 46250-2041
(317) 621-6725
(317) 621-4545
Mailing address
6626 E. 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01073887A
IN
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
01073887A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201226670
—
IN
01
—
P01347726
MEDICARE RR PTAN
IN
Enumeration date
06/21/2007
Last updated
06/13/2023
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