Doctor Name: | VISVALDIS GEORGE NAGOBADS |
NPI Number: | 1588957716 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 13269 |
Business Practice Address: | 5180 Circle Drive Edina, MN - 554391401 |
Business Phone Number: | 9529413113 |
Business Fax Number: | 9529443180 |
Mailing Address: | 5180 Circle Drive, EDINA |
State: | MN |
Postal Code: | 554391401 |
Phone Number: | 9529413113 |
Fax Number: | 9529443180 |
NPI Enumeration Date: | 05/20/2011 |
NPI Last Update Date: | 05/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 13269 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |