Individual
DR. CLARENCE BONOAN AMAYUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3611 S REED RD, SUITE 106, KOKOMO, IN 46902-3828
(765) 453-8001
(765) 453-8002
Mailing address
4070 E 100 N, SUITE106, KOKOMO, IN 46901-8319
(765) 453-8585
(765) 453-8002
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01041643A
IN
Other
Enumeration date
01/25/2006
Last updated
05/04/2009
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