Individual
MANKPONDEHOU ETIENNE DJEVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
(612) 625-3238
Mailing address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
(612) 626-9943
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
55885
MN
207RI0200X
Infectious Disease Physician
Primary
55885
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/06/2009
Last updated
04/11/2022
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