Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 49295-020 | WI |
N | 208600000X | Surgeon | 49295-020 | WI |
Y | 2082S0105X | Plastic Hand Surgeon | 49295-020 | WI |
NPI | 1225023906 |
---|---|
Provider Name | Dr. Amorn Neil Salyapongse |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53715-1375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 04/02/2015 |