Individual
NANTHAYA TISAVIPAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34372
MN
2084N0400X
Neurology Physician
Primary
80308
MN
Other
Enumeration date
03/22/2024
Last updated
08/30/2025
Update your record
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