Wangsuwana, Miracle

Wangsuwana, Miracle is an sole proprietor health care provider with primary practice located at 6900 North Pecos Road 2Nd Floor West Side 2B152 Va Southern Nevada, North Las Vegas NV 89086. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Wangsuwana, Miracle can be contacted via phone (702) 791-9161.

Contact Information

Primary practice address
6900 North Pecos Road 2Nd Floor West Side 2B152 Va Southern Nevada North Las Vegas NV 89086
Phone: (702) 791-9161
Fax: (702) 671-5891
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 1253 Nevada

Profile Details

NPI number 1750377693
LBN Legal business name Wangsuwana, Miracle
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2005
Last updated May 28th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750377693 NPPES
Nevada MEDICAID 100500484

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