Individual
DR. EDWIN NDEMO BOGONKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 SAINT FRANCIS AVE, SUITE # 100, SHAKOPEE, MN 55379-3387
(952) 403-3535
(952) 403-3599
Mailing address
1515 SAINT FRANCIS AVE, SUITE # 100, SHAKOPEE, MN 55379-3387
(952) 403-3535
(952) 403-3599
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
50217
MN
208M00000X
Hospitalist Physician
50217
MN
Other
Enumeration date
08/30/2007
Last updated
03/16/2021
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