Preecha Supanwanid, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

4301037471 Issued in MI

Practice address

921 Abbot Rd
East Lansing, MI 48823-3170

Phone

(517) 336-6950

Fax

(517) 336-6952

NPI assigned

Oct 17, 2007

Last updated

Mar 11, 2008By the provider in NPPES

Sex

Male

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Preecha Supanwanid MD PC

  • Specialist
  • East Lansing, MI
  • NPI 1326227786
  NPD (past) Authorized official
• Preecha Supanwanid, MD PC

  • Plastic Surgery Physician
  • East Lansing, MI
  • NPI 1346238920
  Authorized official Same address or phone

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1669661450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 ABBOT 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 ABBOT RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233170",
            "telephone_number": "517-336-6950",
            "fax_number": "517-336-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPANWANID",
        "first_name": "PREECHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301037471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sana Sumbal
• Abby Sumbler, CD(DONA), LCCE, CLC
• Laila O Sundh, P.T.
• Dukhae A Sung
• Sunset Voyage LLC (Blooming Minds Therapy)
• Kate Meryl Supianoski, PA
• Sruthi Surapaneni
• Emma Rose Surbrook
• Shelby Lynn Sutphen
• Ron William Sutton, C.O CERTIFIED ORTHO.

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.