SUPHICHAYA MUANGMAN (NPI# 1245398619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245398619 |
| Entity Type | Individual |
| Full Name | SUPHICHAYA MUANGMAN |
| Credential | M.D. |
| Practice Address |
1625 Straits Tpke Suite 209 Middlebury CT 06762-1836 |
| Practice Telephone | 2037589100 |
| Practice Fax Number | 2037589400 |
| Mailing Telephone | 2037589100 |
| Mailing Fax Number | 2037589400 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2014-07-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
043440 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BCBS CT | 010043440CT02 | 01 |
| CT | RR MEDICARE | P00796456 | 01 |
| CT | OXFORD | P3941581 | 01 |
| CT | 001153600 | 05 | |
| CT | HEALTHNET/COMMERCIAL | 3V0829 | 01 |
| CT | USA | 1105253 | 01 |
| CT | 001434406 | 05 | |
| CT | WELLCARE | 518685 | 01 |
| CT | AETNA | 7085716 | 01 |
| CT | AMERICHOICE | 25-33213 | 01 |
| CT | CONNECTICARE | 043440 | 01 |
| CT | UHC | 25-33213 | 01 |
| Street Address |
1625 STRAITS TPKE SUITE 209 |
| City | MIDDLEBURY |
| State | CT |
| Zip Code | 06762-1836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357451 | Scott Kurtzman | Surgery | 1625 Straits Tpke, Suite 200, Middlebury, CT 06762-1805 | 2005-06-23 |
| 1245636877 | Stephanie Lauren Gunnoud | Nurse Practitioner | 1625 Straits Tpke, Suite 110, Middlebury, CT 06762-1836 | 2014-11-10 |
| 1942606835 | Stanley J Foster IIi Md PC | Plastic Surgery | 1625 Straits Tpke, Suite 108, Middlebury, CT 06762-1836 | 2014-11-05 |
| 1831590454 | Michael Tanguay | Physician Assistant | 1625 Straits Tpke, Suite 200, Middlebury, CT 06762-1836 | 2014-09-15 |
| 1710316385 | Riddhi Shah | Internal Medicine | 1625 Straits Tpke, Suite 110, Middlebury, CT 06762-1836 | 2013-11-04 |
| 1093079683 | Elizabeth Marie Lucchesi | Dentist | 1625 Straits Tpke, Middlebury, CT 06762-1836 | 2012-06-27 |
| 1164650370 | Juan Diego Holguin | Surgery | 1625 Straits Tpke, Suite 200, Middlebury, CT 06762-1836 | 2009-06-25 |
| 1669625174 | Pooia Fattahi | Neurological Surgery | 1625 Straits Tpke, Suite 307 - Waterbury Neurology LLC, Middlebury, CT 06762-1836 | 2008-10-28 |
| 1679725816 | Zhongqiu John Zhang | Surgery | 1625 Straits Tpke, 200, Middlebury, CT 06762-1836 | 2008-10-21 |
| 1356501944 | O Joseph Bizzozero Jr. | Internal Medicine | 1625 Straits Tpke, 211, Middlebury, CT 06762-1836 | 2008-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164895314 | Naugatuck Valley Womens Health Specialists PC | Obstetrics & Gynecology | 686 Straits Turnpike, 2a, Middlebury, CT 06762 | 2015-11-10 |
| 1588047153 | Princess Corset & Lingerie Shop II, LLC | Durable Medical Equipment & Medical Supplies | 900 Straits Turnpike, Suite 1 G, Middlebury, CT 06762 | 2015-07-01 |
| 1437423985 | Gretchen R. Cianciola | Dental Hygienist | 12 Nantucket Way, Middlebury, CT 06762 | 2012-03-01 |
| 1124395223 | Tlc Homecare LLC | Home Health | 900 Straits Tpke Ste 205, Middlebury, CT 06762 | 2011-11-18 |
| 1588893952 | Catherine Ann Accashian | Occupational Therapist | 778 Middlebury Road, Middlebury Convalescent Center, Middlebury, CT 06762 | 2009-07-07 |
| 1013081819 | Waltor M Phillips | Psychologist | 415 Middlebury Road, Middlebury, CT 06762 | 2006-11-20 |
| 1518922608 | W Kenneth Miner | Physician Assistant | 1579 Straits Turnpike, Turnpike Office Park, Middlebury, CT 06762 | 2006-04-20 |
| 1952366072 | John M Keggi | Orthopaedic Surgery | 1579 Straits Turnpike, Suite E, Orthopaedics New England PC, Middlebury, CT 06762 | 2006-04-20 |
| 1568443125 | Stanley J Foster IIi | Plastic Surgery | 1625 Straits Turnpike, Suite 108, Middlebury, CT 06762 | 2005-11-10 |
| 1932556602 | Karissa Piedescalzo | Social Worker | 850 Straits Tpke Ste 201, Middlebury, CT 06762 | 2016-05-23 |
| Find all providers in zip 06762 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952464158 | Porter Hospital Inc | Internal Medicine | 104 Porter Dr, Middlebury, VT 05753-8527 | 2006-12-18 |
| 1457419814 | George V Antonopoulos | Internal Medicine | 1625 Straits Turnpike, Suite 209, Middlebury, CT 06762 | 2006-12-05 |
| 1053331389 | Porter Hospital Inc | Internal Medicine | 104 Porter Dr, Middlebury, VT 05753-8527 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922527050 | Lindacare Inc. | Internal Medicine | 20 Church St Ste 1780, Hartford, CT 06103-1246 | 2017-09-09 |
| 1740678135 | Post-acute Cardiology Care LLC | Internal Medicine | 30 Old Kings Hwy S Ste 160, Darien, CT 06820-4519 | 2015-01-07 |
| 1144630328 | Allison Padegimas | Internal Medicine | 1062 Barnes Rd Ste 300, Wallingford, CT 06492-2576 | 2014-04-28 |
| 1871913244 | Jason Michael Goodman | Internal Medicine | 111 Osborne St Fl 3, Danbury, CT 06810-6000 | 2014-04-23 |
| 1669899829 | Kyla D'angelo | Internal Medicine | 1260 Silas Deane Hwy Ste 109, Wethersfield, CT 06109-4363 | 2014-03-26 |
| 1598100869 | Seabright Cardiovascular Center, LLC | Internal Medicine | 353 Bridgeport Ave, Milford, CT 06460 | 2013-05-01 |
| 1427311711 | Qurat-ul-ain Jelani | Internal Medicine | Section of Cardiovascular Medicine., Yale New Haven Hospital. 20. York Street, New Haven, CT 06510 | 2012-06-21 |
| 1760744643 | Michael M Cebrik | Internal Medicine | 4 Oxford Court, Avon, CT 06001-4556 | 2012-06-15 |
| 1467710657 | Andrew Beck | Internal Medicine | 112 Quarry Rd Ste 400, Trumbull, CT 06611-4877 | 2012-04-25 |
| 1316203482 | James J Purcell | Internal Medicine | 31 Woodland Street, Apt. 4p, Hartford, CT 06105 | 2012-04-03 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLEBURY |
| Zip Code | 06762 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.