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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

EVERAID UBANGOH FOKIM, MDT

Active Sole Proprietor

EVERAID UBANGOH FOKIM, MDT is a 125J00000X healthcare provider located in COON RAPIDS, Minnesota. NPI 1316617491 is currently active in the NPPES registry. Verify at CMS.

125J00000X · COON RAPIDS, MN

Registration Details

NPI Number
1316617491
Provider Type
Individual
Gender
Male
NPI Issued
Sep 20, 2021 (4.8577304899056 yrs)
Last Updated
Sep 20, 2021
Licenses
H10783 (MN)
DT130 (MN)
Sole Proprietor
Yes

Practice Information

Address
9920 FOLEY BLVD NW
COON RAPIDS, MN, 554334579
Browse MN providers · Browse ZIP 55433
Phone
7633171166
Primary Specialty
125J00000X
125J00000X
Additional Specialty
125J00000X

Other 125J00000X Providers in COON RAPIDS, MN

Name Credential NPI
CONNIE KARJALAHTI RDH 1053565044
NEAL IRION DT 1043464035
MRS. JENNIFER MARIE CAREY RDH 1831553312
MS. THUY NGUYEN DT 1578032793
GEMMA SHIRANI MOSHER ADT124/LDH7581 1104436138
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.