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1881671881
TAWATCHAI PAISANSINSUP
ST LOUIS PARK, MN
NPI
1881671881
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207RR0500X Internal Medicine, Rheumatology
(Licence: MN 42026)
Enumeration Date
2005-12-30
Last Update Date
2021-03-09
Business Address
TAWATCHAI PAISANSINSUP
3800 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416-2527
Phone number: 952-993-2808
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Mailing Address
TAWATCHAI PAISANSINSUP
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 55425-4516
Phone number:
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