Puangpetch Chanbusarakum

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21116 Issued in WI

Practice address

722 Williamson St
Madison, WI 53703-3546

Phone

(608) 267-1445

NPI assigned

Apr 9, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1275656647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 COTTAGE GROVE RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537161309",
            "telephone_number": "608-267-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 WILLIAMSON ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537033546",
            "telephone_number": "608-267-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANBUSARAKUM",
        "first_name": "PUANGPETCH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "21116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Yang Chan, MD
• Dorothy Chan, MD
• Fountane Chan, MD
• Pennapa S Chan, MD
• Krisada Chanbusarakum, M.D.
• Luke William Chandler, C-AA
• Medhavani Dhruv Chandra, MD
• Suresh R Chandra, MD
• Althea W Chang, MS LMFT
• Chen Kang Chang, MD

• Internal Medicine Physician in Madison, WI
• Providers in Madison, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.