Individual
MR. MIGUEL EDUARDO TOBON LASCANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
31 BURLINGTON MALL ROAF, BURLINGTON, MA 01805-0001
(781) 744-5100
Mailing address
31 BURLINGTON MALL RD, BURLINGTON, MA 01803-4138
(941) 266-6770
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301505668
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2014
Last updated
08/16/2022
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