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PERMPORN VANASUPA MD NPI 1679507511


NPI Information

NPI: 1679507511
Provider Name: PERMPORN VANASUPA, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
1225 10TH ST
HURON FAMILY PRACTICE CENTER
PORT HURON, MI
ZIP 48060
Phone: (810) 987-6200
Get Directions

Permporn Vanasupa, MD is a family medicine in Port Huron, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Permporn Vanasupa, MD NPI is 1679507511. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1225 10TH ST
HURON FAMILY PRACTICE CENTER
PORT HURON, MI
ZIP 48060
Phone: (810) 987-6200
Fax: (810) 987-8717

The enumeration date for this NPI number is 7/10/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine40301032135MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1B44778MEDICARE UPIN
24301032135OTHERMICHIGANPHYSICIAN LICENSE NUMBER
33184814MEDICAIDMICHIGAN
4AV9479088OTHERMICHIGANUS FEDERAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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