Individual provider · NPI-1

Dr. Marc T. Awobuluyi, M.D.

Radiology, Diagnostic Radiology · Eden Prairie, MN

NPI number1962512145
StatusActive
Last updated in NPPESJun 25, 2021

Details

NPI
1962512145
Entity type
Individual (NPI-1)
Name
Dr. Marc T. Awobuluyi
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Aug 30, 2006
Certification date
Jun 25, 2021
Last updated
Jun 25, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2085R0202X Radiology, Diagnostic RadiologyA84420CAYes

Practice location

11995 Singletree Ln Ste 500
Eden Prairie, MN 55344-5349

Phone 952-595-1100 · Fax 612-294-4903

Mailing address

11995 Singletree Ln Ste 500
Eden Prairie, MN 55344-5349

Phone 952-595-1100 · Fax 612-294-4903

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Radiology, Diagnostic Radiology providers in Eden Prairie, MN