Individual
EVIDIO DOMINGO MUSIBAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E 28TH ST STE 401, MINNEAPOLIS, MN 55407-3723
(612) 863-0200
(612) 863-0235
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
(612) 262-9035
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
52977
MN
207RH0000X
Hematology (Internal Medicine) Physician
52977
MN
207RX0202X
Medical Oncology Physician
Primary
52977
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
01
—
P01075996
RAIL ROAD - MEDICARE
MN
Enumeration date
08/11/2009
Last updated
06/25/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us