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Individual

MISHA AMAGASU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1162 WILLAMETTE ST, ATTN: CAROL CRAYS, EUGENE, OR 97401-3568
(541) 687-6373
(541) 434-3164
Mailing address
1515 VILLAGE DR, COTTAGE GROVE, OR 97424-9700

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD23945
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
227402
OR
Enumeration date
06/20/2006
Last updated
07/08/2007
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