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Individual

MR. LUCIO N MARGALLO II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1115 E 5TH AVE, MITCHELL, SD 57301-2917
(605) 996-5553
(605) 996-1213
Mailing address
1115 E 5TH AVE, MITCHELL, SD 57301-2917
(605) 996-5553
(605) 996-1213

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2266
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
460273800
TAX ID
01
4602738000000E
COMMERCIAL NUMBER ON COMP
05
6000720
SD
Enumeration date
09/05/2006
Last updated
10/24/2013
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