Preecha Supanwanid, MD PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

4301037471 Issued in MI

Legal business name

PREECHA SUPANWANID, MD PC

Practice address

921 Abbott Rd
East Lansing, MI 48823-3170

Phone

(517) 336-6950

Fax

(517) 336-6952

NPI assigned

Oct 8, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Preecha Supanwanid, MD

Title

President

Phone

(517) 336-6950

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1128729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1346238920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 ABBOTT RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233170",
            "telephone_number": "517-336-6950",
            "fax_number": "517-336-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 ABBOTT RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233170",
            "telephone_number": "517-336-6950",
            "fax_number": "517-336-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREECHA SUPANWANID, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-08",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "SUPANWANID",
        "authorized_official_first_name": "PREECHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-336-6950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301037471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John W. Powell, PHD, ATC
• Samantha Poyer
• Praising Jesus Christ for Life LLC (More Space Mental Health)
• Precision Counseling
• Preecha Supanwanid MD PC
• Premier Counseling and Wellness Institute
• Prestige Mindsets Counseling
• Kimberly Preston
• Mick Allen Preston Jr., RN
• Lino Tusten Pretto, LMT

• Plastic Surgery Physician in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.