PEERAWUT DEEPRASERTKUL (NPI# 1144466111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144466111 |
| Entity Type | Individual |
| Full Name | PEERAWUT DEEPRASERTKUL |
| Practice Address |
1301 15th Ave W Williston ND 58801-3821 |
| Practice Telephone | 7017747409 |
| Mailing Telephone | 7017747409 |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2016-06-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 237179 | MA | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
PT 14024 | ND | Allopathic & Osteopathic Physicians |
| Street Address |
1301 15TH AVE W |
| City | WILLISTON |
| State | ND |
| Zip Code | 58801-3821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922006519 | Advanced Diagnostic Radiology PC | Radiology | 1301 15th Ave W, Williston, ND 58801-3821 | 2005-07-08 |
| 1487251930 | Elizabeth Coulson | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2020-10-07 |
| 1700420288 | Heather Rose Hass | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-10-29 |
| 1740822584 | Anna Elizabeth Wolf | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-10-14 |
| 1124678297 | Janet Williams | Registered Nurse | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-09-19 |
| 1396394904 | Chelsea Nichole Smith | Advanced Practice Midwife | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-09-06 |
| 1952959868 | Kaleb Barstad | Pharmacist | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-09-04 |
| 1447819586 | Craig D White | Registered Nurse | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-06-12 |
| 1043780828 | Yesul Song | Pharmacist | 1301 15th Ave W, Williston, ND 58801-3821 | 2018-12-05 |
| 1467938399 | Melissa Sue Gilbertson | Physician Assistant | 1301 15th Ave W, Williston, ND 58801 | 2018-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952868556 | Purpose Driven Interventions | Counselor | 1502 13th Ave West, Williston, ND 58801 | 2019-03-01 |
| 1437637501 | Camille Ann Settelmeyer | Nurse Practitioner | 1213 15th Avenue West, Williston, ND 58801 | 2018-08-01 |
| 1801317417 | Shelby Laine Carlson | Physical Therapist | 1502 13th Ave W Suite 101, Williston, ND 58801 | 2017-07-05 |
| 1710418579 | Catrina Louise Lindvig | Chiropractor | 1135 2nd Ave W Ste 203, Williston, ND 58801 | 2017-03-23 |
| 1801337415 | Selah Counseling | Clinic/Center | 125 Main St, Suite #220, Williston, ND 58801 | 2017-03-15 |
| 1316485634 | Theresa E Scully | Social Worker | 125 Main St; Unit 220, Williston, ND 58801 | 2017-02-07 |
| 1346792256 | Donna Peterson | Social Worker | 1500 14th St Sw, Suite 250, Williston, ND 58801 | 2016-10-26 |
| 1730509084 | Lacey Thompson | Case Manager/Care Coordinator | 110 West Broadway, Suite 202, Williston, ND 58801 | 2014-04-24 |
| 1770904708 | Kayla Jo Rossland | Physical Therapist | 221 University Ave Ste 203, Williston, ND 58801 | 2013-12-17 |
| 1285072710 | Susan Mae Bradford | Counselor | 612 4th St. E., Williston, ND 58801 | 2013-06-06 |
| Find all providers in zip 58801 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881896223 | Rabeea Aboufakher | Internal Medicine | 1300 S Columbia Rd - Altru 1300 Columbia, Grand Forks, ND 85201-4012 | 2007-06-05 |
| 1952485740 | Noah N Chelliah | Internal Medicine | 1191 South Columbia Road, Grand Forks, ND 58201 | 2006-10-25 |
| 1003923780 | Nicholas C Mahr | Internal Medicine | 310 N 10th Street, Bismarck, ND 58501-4516 | 2006-08-25 |
| 1841245743 | Larry Steven Sidaway | Internal Medicine | 3000 32nd Avenue South, Essentia Health 32nd Avenue Clinic, Fargo, ND 58103-6132 | 2006-05-23 |
| 1730132655 | Radomysl M Twardowski | Internal Medicine | 2937 Carriage Cir, Bismarck, ND 58503-0113 | 2006-05-19 |
| 1972919942 | Puvanalingam Ayyadurai | Internal Medicine | 1300 S Columbia Rd, Grand Forks, ND 58201-4012 | 2014-07-10 |
| 1528471810 | Sundermurthy Yamini | Internal Medicine | 222 N 7th St, Bismarck, ND 58501-4436 | 2014-06-04 |
| 1316368236 | Nayan K Desai | Internal Medicine | 300 N 7th St, Bismarck, ND 58501-4439 | 2013-12-18 |
| 1841550357 | Oludamilola Wuraola Oluleye | Internal Medicine | 3000 32nd Ave South, Fargo, ND 58103 | 2012-05-18 |
| 1104137405 | Stephen Asante Boateng | Internal Medicine | 222 N 7th St, Bismarck, ND 58501-4436 | 2010-07-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PEERAWUT DEEPRASERTKUL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.