DR. MIRACLE WANGSUWANA (NPI# 1750377693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750377693 |
| Entity Type | Individual |
| Full Name | DR. MIRACLE WANGSUWANA |
| Credential | D.O. |
| Practice Address |
1707 W Charleston Blvd Suite #220 Las Vegas NV 89102-2351 |
| Mailing Address |
1701 W Charleston Blvd 215 Las Vegas NV 89102-2325 |
| Practice Telephone | 7026715070 |
| Practice Fax Number | 7026715072 |
| Mailing Telephone | 7026715070 |
| Mailing Fax Number | 7026715072 |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2014-12-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
1253 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 100500484 | 05 |
| Street Address |
1707 W CHARLESTON BLVD SUITE #220 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89102-2351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073040127 | Evan Drew Davis | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Las Vegas, NV 89102-2351 | 2017-05-19 |
| 1336674969 | Bobby Karandeep Singh Brar | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Suite 120, Las Vegas, NV 89102-2351 | 2017-04-20 |
| 1497280036 | Pooja Patil | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Suite 120, Las Vegas, NV 89102-2351 | 2017-04-20 |
| 1346772597 | Angela Hui-chia Liu | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Suite 120, Las Vegas, NV 89102-2351 | 2017-03-28 |
| 1902345077 | Ankita Raman | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Ste 120, Las Vegas, NV 89102-2351 | 2017-02-22 |
| 1669852513 | Cameron Lasley | Student in an Organized Health Care Education/Training Program | 1707 W Charleston Blvd, Suite 290, Las Vegas, NV 89102-2351 | 2015-06-05 |
| 1043627508 | Richard Witty Jr. | Dentist | 1707 W Charleston Blvd, Suite 290, Las Vegas, NV 89102-2351 | 2014-07-16 |
| 1346657285 | Jacqueline Sanders Delaney | Dentist | 1707 W Charleston Blvd, Suite 290, Las Vegas, NV 89102-2351 | 2014-07-11 |
| 1710305156 | Ali Osama Malik | Internal Medicine | 1707 W Charleston Blvd, Las Vegas, NV 89102-2351 | 2014-04-02 |
| 1881026177 | Wendy Seto | Dentist | 1707 W Charleston Blvd, Suite 290, Las Vegas, NV 89102-2351 | 2013-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998397 | Natasha Moore | Technician | 3210 W Charleston Suite 2, Las Vegas, NV 89102 | 2020-10-07 |
| 1568077113 | Zulma Yaneth Tervizo Lopez | Technician | 455 W Oakey Blvd, Ste 111, Las Vegas, NV 89102 | 2020-09-10 |
| 1922629765 | Bianca Vaudreuil | Religious Nonmedical Practitioner | 3210 W Charleston Ste 2, Las Vegas, NV 89102 | 2020-05-04 |
| 1720608052 | Angelica Gutierrez | Technician | Vegas Compassionate Care ; 2820 W. Charleston Blvd B-21, Las Vegas, NV 89102 | 2020-04-16 |
| 1396370680 | Juana Maria Hernandez | Technician | 2881 S. Valley View Blvd, Suite #6, Las Vegas, NV 89102 | 2020-03-06 |
| 1609409648 | Janie Washington | Technician | 3210 W Charleston Blvd. Suite 2, Las Vegas, NV 89102 | 2020-02-18 |
| 1447893185 | Maria Josefina Castaneda | Technician | 2881 S. Valley View Blvd Suite #6, Los Vegas, NV 89102 | 2019-10-25 |
| 1427608777 | Virginia Hernandez Tolentino | Technician | 4550 W Oakley Blvd, Suite 101 A, Las Vegas, NV 89102 | 2019-09-18 |
| 1972153872 | Gladiola Cardoza Quinones | Technician | 2881 S. Valley View Blvd #6, Las Vegas, NV 89102 | 2019-09-13 |
| 1801445572 | Rafael Roberto Gonzalez Palomino | Homemaker | 4550 W. Oakey Blvd, Suite 111-0, Las Vegas, NV 89102 | 2019-09-05 |
| Find all providers in zip 89102 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760982367 | Centennial Neurology LLC | Psychiatry & Neurology | 7425 W Azure Dr Ste 150, Las Vegas, NV 89130-4425 | 2018-02-20 |
| 1457731242 | Janda, Mahajan & Balsiger Pllc | Psychiatry & Neurology | 2010 Wellness Way # 306, Las Vegas, NV 89106 | 2015-06-05 |
| 1184011330 | Eric Ryan Gutglueck | Psychiatry & Neurology | 7751 W Flamingo Rd A100, Las Vegas, NV 89147-4399 | 2015-04-24 |
| 1033532833 | Valencia Neurology PC | Psychiatry & Neurology | 7500 W Lake Mead Blvd Ste 9, Box 467, Las Vegas, NV 89128-1000 | 2014-01-29 |
| 1760733414 | Arlyn Valencia Md PC | Psychiatry & Neurology | 7500 W Lake Mead Blvd # 9-467, Las Vegas, NV 89128-0297 | 2012-09-20 |
| 1740548866 | Brian Ahuja | Psychiatry & Neurology | 49 Alamere Falls Dr, Las Vegas, NV 89138-6155 | 2012-04-26 |
| 1972833440 | Juanidad Corporation | Psychiatry & Neurology | 209 Dalmatian Ln, Las Vegas, NV 89107-2304 | 2010-01-06 |
| 1942443072 | Carrie Michelle Hersh | Psychiatry & Neurology | 888 W Bonneville Avenue, Las Vegas, NV 89106 | 2009-04-20 |
| 1285894881 | Gerald Wayne Dunn | Psychiatry & Neurology | 10432 Profondo Ct, Las Vegas, NV 89135-2564 | 2008-06-17 |
| 1497924468 | Paul Harlan Janda | Psychiatry & Neurology | 2010 Wellness Way Ste 306, Las Vegas, NV 89106-4142 | 2008-02-25 |
| Find all providers in LAS VEGAS | ||||
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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.