Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 101123 | MO |
NPI | 1003872615 |
---|---|
Provider Name | Dr. Vorachart Auethavekiat |
First Address | Saint Louis, MO 63106-1621 |
Second Address | Saint Louis, MO 63106-1621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2006 |
Last Update Date | 08/07/2007 |