Individual
PROMPAN MINGBUNJERDSUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
75195
WI
2084N0400X
Neurology Physician
9408557
KS
Other
Enumeration date
04/14/2015
Last updated
08/10/2023
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