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Permporn Vanasupa, MD
Family Medicine Physician in Port Huron, Michigan
NPI 1679507511

Permporn Vanasupa is a Family Medicine Physician based in Troy, MI. Permporn Vanasupa practices in Port Huron, MI and has the professional credentials of MD. The NPI Number for Permporn Vanasupa is 1679507511 and holds a License No. 40301032135 (Michigan).

The current practice location address for Permporn Vanasupa is 1225 10Th St, Port Huron, MI and can be reached out via phone at 810-987-6200 and via fax at 810-987-8717.

Location: 1225 10Th St, Port Huron, MI, 48098
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679507511
Provider Name
Permporn Vanasupa
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1225 10Th St, Port Huron, MI, 48098
Phone Number
810-987-6200
Fax Number
810-987-8717
Provider Enumeration Date
07/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AV9479088 01 MI US FEDERAL
4301032135 01 MI PHYSICIAN LICENSE NUMBER
3184814 05 MI
institution
Provider Business Practice Location Address Details
Address
1225 10Th St
City
Port Huron
State
Michigan
Zip
48060
Phone Number
810-987-6200
Fax Number
810-987-8717
person
Provider Business Mailing Address Details
Address
1225 10Th St
City
Port Huron
State
Michigan
Zip
48060
Phone Number
810-987-6200
Fax Number
810-987-8717
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
40301032135 (Michigan)
Definition
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.
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