Provider Demographics
NPI:1174759179
Name:TANPAIBOON, PRANOOT (MD)
Entity type:Individual
Prefix:DR
First Name:PRANOOT
Middle Name:
Last Name:TANPAIBOON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MICHIGAN AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2916
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MAHARAJ NAKORN CHIANG MAI HOSPITAL
Practice Address - Street 2:110 INTAVAROROD ROAD
Practice Address - City:MUANG
Practice Address - State:CHIANG MAI
Practice Address - Zip Code:50200
Practice Address - Country:TH
Practice Address - Phone:011665-394-5412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47496-020207SG0201X, 207SG0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0202XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Biochemical Genetics
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)