Healthcare Provider Details

I. General information

NPI: 1326239849
Provider Name (Legal Business Name): AMNUAY SINGHAKOWINTA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

785 N LAPEER RD
LAKE ORION MI
48362-4012
US

IV. Provider business mailing address

785 N LAPEER RD
LAKE ORION MI
48362-4012
US

V. Phone/Fax

Practice location:
  • Phone: 248-693-6238
  • Fax:
Mailing address:
  • Phone: 248-693-6238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License NumberAS031305
License Number StateMI

VIII. Authorized Official

Name: AMNUAY SINGHAKOWINTA
Title or Position: PRESIDENT
Credential: M.D. P.C.
Phone: 248-693-6238