Individual
APICHAI JARENWATTANANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W BROWN DEER RD, SUITE 202, BAYSIDE, WI 53217-1618
(414) 434-0461
Mailing address
500 W BROWN DEER RD, SUITE 202, BAYSIDE, WI 53217-1618
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
27997
WI
Other
Enumeration date
11/29/2005
Last updated
05/29/2014
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