Individual
MANUEL A. IDROGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
580 RICE ST, SAINT PAUL, MN 55103-2148
(651) 227-6551
(651) 665-0684
Mailing address
580 RICE ST, SAINT PAUL, MN 55103-2148
(651) 227-6551
(651) 665-0684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37997
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-10998
MEDICA
MN
01
—
1012167
PREFERRED ONE
MN
01
—
109254
UCARE
MN
05
—
225019500
—
MN
05
—
2516896
—
IA
05
—
31738900
—
WI
01
—
58D76IN
BCBS
MN
01
—
768169
AMERICA'S PPO
MN
01
—
HP21967
HEALTHPARTNERS
MN
Enumeration date
11/28/2006
Last updated
07/09/2007
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