Organization
WILSON T ASFORA MD FRCSC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILA CAMPOS (MANAGER)
(305) 646-9797
Entity
Organization
Contact information
Practice address
6709 S MINNESOTA AVE STE 206A, SIOUX FALLS, SD 57108-2593
(305) 646-9797
Mailing address
2601 S. MINNESOTA AVENUE, SUITE 105 MB385, SIOUX FALLS, SD 57105
(305) 646-9797
(305) 921-9682
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336355379
—
SD
Enumeration date
09/16/2020
Last updated
09/16/2020
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