Provider Demographics
NPI:1508217944
Name:CHAROEN, AMBER (MD)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:CHAROEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:ATSAWARUNGRUANGKIT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9500 S DADELAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2866
Mailing Address - Country:US
Mailing Address - Phone:786-530-3820
Mailing Address - Fax:305-675-3378
Practice Address - Street 1:7114 W HOOD PL STE 433
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-6712
Practice Address - Country:US
Practice Address - Phone:509-734-4885
Practice Address - Fax:509-734-2576
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD92813207RG0100X
RIMD16624207RG0100X
WAMD61460424207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology