NPI 1649567926 · live from the CMS NPI Registry
Charoen Mankongpaisarnrung, M.D.
Internal Medicine, Gastroenterology in Saint Paul, MN. National Provider Identifier 1649567926, active.
NPI record
| NPI | 1649567926 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Gastroenterology 207RG0100X |
| Practice location | 435 Phalen Blvd, Saint Paul, MN 55130 |
| Practice phone | 651-254-8680 |
| Mailing address | 8170 33rd Ave S, Ms 21110q, Bloomington, MN 55425 |
| Enumerated | July 7, 2011 |
| Last updated | July 21, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Gastroenterology | 207RG0100X | 10178 (SD) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Internal Medicine, Gastroenterology primary | 207RG0100X | 70746 (MN) |
| Internal Medicine, Gastroenterology | 207RG0100X | MD042302 (DC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.