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Individual

HIAWATHA DAVID MARBAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2000
Mailing address
1270 E EDGEWOOD ST, SPRINGFIELD, MO 65804-3615
(210) 593-0811

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2010007775
MO

Other

Enumeration date
12/04/2012
Last updated
12/04/2012
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