Individual
ESAYAS OKUBAMICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 6TH AVE N, SAINT CLOUD, MN 56303
(320) 252-5131
(320) 255-5973
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2736
(320) 252-5131
(320) 255-5973
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
63039
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2015
Last updated
03/29/2023
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