Individual
DR. OWEN MOGABGAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
107 MARYLAND DR, LULING, LA 70070
(985) 308-1604
(985) 308-1605
Mailing address
2730 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5939
(337) 369-9213
(337) 367-9624
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
228777
MA
207RC0000X
Cardiovascular Disease Physician
BP1-0038347
TX
207RC0000X
Cardiovascular Disease Physician
Primary
MD.206730
LA
Other
Enumeration date
01/26/2007
Last updated
03/22/2018
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