MEDHA SUWANAWONGSE

HERRIN, IL
NPI1366452443
Other NameMEHTA SUWANA
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208600000X Surgery
(Licence: IL  036087814)
Enumeration Date2006-08-09
Last Update Date2008-07-23
Business Address
-- MEDHA SUWANAWONGSE MD
121 N 13TH ST
HERRIN, IL 62948-3248
Phone number: 618-988-6025
Mailing Address
-- MEDHA SUWANAWONGSE MD
PO BOX 129 121 NORTH 13TH STREET
HERRIN, IL 62948-0129
Phone number: 618-988-6025
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