Individual
SUCHINT WATHANACHAROEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3901 RAINBOW BLVD, PROFESSIONAL SERVICES OF KU HOSPITAL, KANSAS CITY, KS 66160-0001
(913) 588-7743
(913) 588-9786
Mailing address
2330 SHAWNEE MISSION PKWY, MEDICAL ADMINISTRATIVE SERVICES OF KU MED. STE 312, WESTWOOD, KS 66205-2005
(903) 588-9000
(913) 588-9822
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
04-17385
KS
2086S0129X
Vascular Surgery Physician
04-17385
KS
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
04-17385
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03077025
BCBS PSKU PROVIDER NUMBER
—
01
—
10001081901
CHP PROVIDER NUMBER
—
01
—
4002033
AETNA
—
01
—
513021
PSKU FIRSTGUARD
—
Enumeration date
08/31/2006
Last updated
11/14/2007
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