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Individual

DR. JUAN CARLOS SAMAYOA ESCOBAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6000
Mailing address
1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3727

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
72902
MN
2080P0202X
Pediatric Cardiology Physician
MD61213463
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1629411970
WA
Enumeration date
04/16/2013
Last updated
12/15/2022
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