Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 131231 | OH |
NPI | 1417237116 |
---|---|
Provider Name | Dr. Sirada Panupattanapong |
First Address | Cleveland, OH 44113-5801 |
Second Address | Cleveland, OH 44195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2011 |
Last Update Date | 17/03/2018 |