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PROMPORN SUWANABOL
Medical Physician Assistant
NPI: 1710395058IndividualAccepts Medicare
Specialties, Licenses & Credentials
Medical Physician AssistantPrimary
Physician Assistant — Medical
Code: 363AM0700X
3398-23(WI)
CMS Specialties
PrimaryPHYSICIAN ASSISTANT
Education
OTHER
Class of 2014
Contact & Hours
- Address
- 123 HOSPITAL DR, SUITE 2009
WATERTOWN, WI 53098 - Phone
- (920) 262-9833
Quick Facts
- NPI
- 1710395058
- Entity Type
- Individual
- Gender
- Female
- Medicare
- Accepted
- Specialties
- 1
- Locations
- 1
- Years in Practice
- 12
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