Provider Demographics
NPI:1790785244
Name:SAPTHAVEE, SANGUAN (MD)
Entity Type:Individual
Prefix:
First Name:SANGUAN
Middle Name:
Last Name:SAPTHAVEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SANGUAN
Other - Middle Name:
Other - Last Name:SAPTHAVEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MDSC
Mailing Address - Street 1:550 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-5975
Mailing Address - Country:US
Mailing Address - Phone:309-797-2567
Mailing Address - Fax:
Practice Address - Street 1:3319 SPRING ST
Practice Address - Street 2:202A
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2125
Practice Address - Country:US
Practice Address - Phone:563-355-6236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology