Individual provider · Type 1 NPI
Supavich Tannumsaeng, MD
Student in an Organized Health Care Education/Training Program · Greenville, NC
Practice location
2100 Stantonsburg Road, Ecu Health Medical Center
Greenville, NC 27834
Fax (252) 744-3811
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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About NPI 1669212221
Supavich Tannumsaeng, MD's National Provider Identifier is 1669212221, issued on May 30, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Greenville, NC. The record was last updated on Sep 27, 2024.