Individual
PRADUB SUKHUM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
20098
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109310
UCARE
—
01
—
2114056
FIRST HEALTH PLAN
—
01
—
2528849
MEDICA HEALTH PLANS
—
01
—
600816
ARAZ GROUP AMERICAS PPO
—
01
—
6D091SU
BLUE CROSS BLUE SHIELD
—
01
—
986029
PREFERRED ONE
—
01
—
HP25524
HEALTH PARTNERS
—
Enumeration date
09/15/2005
Last updated
07/08/2007
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