Individual
KWAME EAGLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 S COLUMBIA RD, DEPARTMENT OF ANESTHESIOLOGY, GRAND FORKS, ND 58201-4036
(701) 780-5000
Mailing address
2397A S 36TH ST, GRAND FORKS, ND 58201-8841
(713) 416-2703
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
TP10034748
TX
Other
Enumeration date
06/10/2009
Last updated
08/23/2013
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