PREECHA SUPANWANID MD PC (NPI# 1326227786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326227786 |
| Entity Type | Organization |
| Organization Name | PREECHA SUPANWANID MD PC |
| Practice Address |
921 Abbot Rd East Lansing MI 48823-3170 |
| Practice Telephone | 5173366950 |
| Practice Fax Number | 5173366952 |
| Mailing Telephone | 5173366950 |
| Mailing Fax Number | 5173366952 |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2007-11-01 |
| Authorized Official Name | DR. PREECHA SUPANWANID (BUSINESS OWNER) |
| Authorized Official Telephone | 5173366950 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 4301037471 | MI | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | 0338503 | 01 | |
| MI | 1391276 | 05 |
| Street Address |
921 ABBOT RD |
| City | EAST LANSING |
| State | MI |
| Zip Code | 48823-3170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669661450 | Preecha Supanwanid | Plastic Surgery | 921 Abbot Rd, East Lansing, MI 48823-3170 | 2007-10-17 |
| 1407025448 | Yusuff Abdullah | Social Worker | 921 Abbot Rd, East Lansing, MI 48823-3170 | 2008-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144848631 | Joseph Santangelo | Technician | 2775 E Lansing Dr, East Lansing, MI 48823 | 2020-07-10 |
| 1679197701 | Alexandra Megan Bauer | Technician | 3839 Hunsaker Street, 121, East Lansing, MI 48823 | 2020-06-04 |
| 1689297756 | Nathan Barnhurst | Neuromusculoskeletal Medicine & OMM | 4660 Hagadorn Rd #500, East Lansing, MI 48823 | 2020-05-25 |
| 1861036006 | Rachel Amber Kelly | Registered Nurse | 221 W Lake Rd, #300, East Lansing, MI 48823 | 2019-10-31 |
| 1982176442 | Thomas Patrick Lilley | Occupational Therapist | 2900 Hannah Blvd. - Suite B102, East Lansing, MI 48823 | 2018-12-21 |
| 1386114684 | Anne Colleen Jack | Social Worker | 3100 West Road, East Lansing, MI 48823 | 2018-11-29 |
| 1346721420 | Mary Ann Malosh | Health Educator | 6265 Fenwick Ct, East Lansing, MI 48823 | 2018-08-27 |
| 1639668734 | Jennifer Lynn Box | Occupational Therapist | 2900 Hannah Blvd Ste. B102, Outpatient Rehab, East Lansing, MI 48823 | 2018-05-03 |
| 1598267288 | Wise Willow Counseling & Consulting LLC | Social Worker | 2875 Northwind Dr Ste 215, East Lansing, MI 48823 | 2018-03-08 |
| 1184142010 | Carlrianna Taylor | Technician | 2775 E Lansing Rd, E Lansing, MI 48823 | 2017-08-30 |
| Find all providers in zip 48823 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861638785 | Dolphindx Michigan Holdings Inc. | Specialist | 4990 Northwind Dr Ste 122, East Lansing, MI 48823-5091 | 2008-12-23 |
| 1386790681 | Jacques Hochglaube | Specialist | 1090 Abbott Rd, East Lansing, MI 48823-2661 | 2007-01-27 |
| 1275639874 | Bruce Wolf | Specialist | 804 Service Rd # A204, East Lansing, MI 48824-7015 | 2006-09-15 |
| 1871557462 | David L Joseph | Specialist | 1500 Abbot Rd, Suite #400, East Lansing, MI 48823-1222 | 2006-04-12 |
| 1639543507 | Dawn Judith Brunner | Specialist | 2775 E Lansing Dr, East Lansing, MI 48823-7755 | 2015-11-16 |
| 1063831725 | Chanel Raddatz | Specialist | 2775 E Lansing Dr, East Lansing, MI 48823-7755 | 2014-04-09 |
| 1598198939 | Natalie Denise Boyer | Specialist | 201 1/2 E Grand River Ave, Suite 19, East Lansing, MI 48823-4323 | 2013-08-20 |
| 1316268840 | Katrina Betros-howell | Specialist | 2775 E Lansing Dr, East Lansing, MI 48823-7755 | 2010-06-18 |
| 1982924213 | Ana Mari Woehr | Specialist | 2775 E Lansing Dr, East Lansing, MI 48823-7755 | 2010-06-09 |
| 1851588099 | Doctor's Approach Dermatology & Laser Center, PC | Specialist | 2900 Hannah Blvd, Suite 114, East Lansing, MI 48823-5384 | 2007-10-02 |
| Find all providers in EAST LANSING | ||||
| City | EAST LANSING |
| Zip Code | 48823 |
Please comment or provide details below to improve the information on PREECHA SUPANWANID MD PC.
| 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.