Individual
DR. MIRACLE WANGSUWANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6900 NORTH PECOS ROAD, 2ND FLOOR WEST SIDE 2B152 VA SOUTHERN NEVADA, NORTH LAS VEGAS, NV 89086
(702) 791-9161
(702) 671-5891
Mailing address
6900 NORTH PECOS ROAD, 2ND FLOOR WEST SIDE 2B 152 VA SOUTHERN NEVADA, NORTH LAS VEGAS, NV 89086
(702) 791-9161
(702) 895-4014
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
1253
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100500484
—
NV
Enumeration date
09/26/2005
Last updated
05/28/2024
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