Individual
TAWATCHAI PAISANSINSUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-2808
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
42026
MN
Other
Enumeration date
12/30/2005
Last updated
03/09/2021
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