Individual
EVANS O MAGAMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
815 2ND ST SE, LITTLE FALLS, MN 56345-3505
(320) 632-5441
(320) 631-5616
Mailing address
3699 CAVALLO PASS, CHASKA, MN 55318-3602
(612) 816-8815
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
54956
MN
207Q00000X
Family Medicine Physician
1105182A
IN
207Q00000X
Family Medicine Physician
54956
MN
Other
Enumeration date
07/16/2009
Last updated
08/19/2019
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