Individual
DR. JOHN ROBERT MBAGWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
11000 OPTUM CIR, EDEN PRAIRIE, MN 55344-2503
(952) 205-0323
Mailing address
11000 OPTUM CIR, EDEN PRAIRIE, MN 55344-2503
(952) 205-0323
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
121083
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121083
PHARMACIST LICENSE
MN
Enumeration date
11/10/2012
Last updated
08/21/2015
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