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Individual

MATTHEW J BROGHAMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 454-3680
Mailing address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 454-3680

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
45674
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
028891800
MN
Enumeration date
08/08/2006
Last updated
12/13/2011
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