Individual
KANYA VANADURONGVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
803 E MILBANK AVE, MILBANK, SD 57252-1413
(605) 432-4587
(605) 432-4580
Mailing address
13516 SODAK RD, WILMOT, SD 57279-8211
(605) 938-4574
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2408
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299363500
—
MN
05
—
6700334
—
SD
Enumeration date
04/17/2006
Last updated
03/07/2023
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