IndividualActive
Chanchai Tivitmahaisoon, M.D.
NPI 1508820549 · Surgery Physician · Logan, WV
Provider details
- NPI number
- 1508820549
- Entity type
- Individual
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- License
- 11491 (WV)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
20 Hospital Dr
Logan, WV 25601-3452
Phone: (304) 831-1254
Fax: (304) 831-1679
Approximate (ZIP-level) locationGet directions
Mailing address
20 Hospital Dr
Logan, WV 25601-3452
Registry dates
- Enumerated
- 2006-04-14
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.