Individual
SAKDIDEJ SUWAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
419 MARKET ST, FREEPORT, PA 16229-1121
(724) 295-5202
(724) 295-1160
Mailing address
419 MARKET ST, FREEPORT, PA 16229-1121
(724) 295-5202
(724) 295-1160
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD014710Y
PA
207RI0200X
Infectious Disease Physician
Primary
MD014710Y
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006560810001
—
PA
01
—
165045
BLUE SHEILD
PA
Enumeration date
03/09/2006
Last updated
09/11/2025
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