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Individual
ERNESTO BOGARIN MIRANDA
Active
Individual
ERNESTO BOGARIN MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
73153-20
WI
207Q00000X
Family Medicine Physician
RL14696
ND
207R00000X
Internal Medicine Physician
R74574
AZ
Other
Enumeration date
07/25/2014
Last updated
10/07/2022
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