Individual
WASAWAT VUTTHIKRAIVIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1380 E MEDICAL CENTER DR, ST GEORGE, UT 84790-2123
(435) 656-4907
(435) 656-4907
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
R-11718
IA
207RI0011X
Interventional Cardiology Physician
Primary
13320150-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
BP10059587
TX
Other
Enumeration date
07/12/2017
Last updated
08/27/2024
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