Individual
EDWIN MGBAM
Active
Individual
EDWIN MGBAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33253
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88130101
—
AZ
Enumeration date
03/23/2006
Last updated
03/02/2012
Update your record
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