Provider Demographics
NPI:1639331796
Name:ANUPANSAWANG, WUTTHIWAT (MD)
Entity Type:Individual
Prefix:MR
First Name:WUTTHIWAT
Middle Name:
Last Name:ANUPANSAWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11477 MAYFIELD RD APT 720
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-5905
Mailing Address - Country:US
Mailing Address - Phone:773-837-6159
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:GENERAL SURGERY DEPARTMENT
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-5905
Practice Address - Country:US
Practice Address - Phone:773-837-6159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program