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General NPI Number Information
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NPI Number | 1841570140
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Entity Type | Individual
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Provider Name | PRASONGCHAI SATTAYAPRASERT M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/18/2011
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 640 JACKSON ST
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City | SAINT PAUL
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State | MN
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Zip | 55101-2502
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Country | US
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Telephone | 651-254-4887
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1230
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City | EVANSVILLE
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State | IN
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Zip | 47706-1230
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Country | US
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Telephone | 812-450-6815
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125059246
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 57.022011
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 53110
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 01082640A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 79699
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License Number State | MN
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