Individual
MIGUEL ANGEL MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1900 SOUTH SUNSHINE AVE., SPRINGFIELD, MO 65807
(417) 862-7041
Mailing address
1900 SOUTH SUNSHINE AVE., SPRINGFIELD, MO 65807
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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