Provider Demographics
NPI:1437194784
Name:WILLIAMS, PILAIPUN (MD)
Entity Type:Individual
Prefix:
First Name:PILAIPUN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PILAIPUN
Other - Middle Name:
Other - Last Name:SAENGSAMRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11011 SANDISTAN MANOR CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5588
Mailing Address - Country:US
Mailing Address - Phone:314-932-5690
Mailing Address - Fax:314-932-5692
Practice Address - Street 1:5701 CHIPPEWA ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1544
Practice Address - Country:US
Practice Address - Phone:314-932-5690
Practice Address - Fax:314-932-5692
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004023928207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200778900Medicaid
I50697Medicare UPIN
MO939232717Medicare ID - Type Unspecified