Healthcare Provider Details

I. General information

NPI: 1588123301
Provider Name (Legal Business Name): PIYAWAT ARICHAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PIYAWAT SUKIJTHAMAPAN

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVENUE ML 7009
CINCINNATI OH
45229
US

V. Phone/Fax

Practice location:
  • Phone: 617-304-8517
  • Fax:
Mailing address:
  • Phone: 202-476-3670
  • Fax: 202-476-4741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.152821
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: