Individual
SOMPOP SRISUWANANUKORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2075 INDIANAPOLIS BLVD, WHITING, IN 46394-1948
(219) 659-7000
(219) 659-9018
Mailing address
9201 CALUMET AVE, MUNSTER, IN 46321-2807
(219) 836-2022
(219) 836-1072
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01030518
IN
207RP1001X
Pulmonary Disease Physician
Primary
01030518
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100188330
—
IN
Enumeration date
12/28/2005
Last updated
01/16/2015
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