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1295399186
KEVIN DALE MANGUM
ANN ARBOR, MI
NPI
1295399186
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MI 4351044158)
Enumeration Date
2019-04-25
Last Update Date
2019-04-25
Business Address
KEVIN DALE MANGUM MD
1500 E MEDICAL CENTER DRIVE SPC 5856 FCVC 3RD FLOOR, RECEPTION B
ANN ARBOR, MI 48109-5856
Phone number: 734-936-5850
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Mailing Address
KEVIN DALE MANGUM MD
1500 E MEDICAL CENTER DRIVE 5346 CVC
ANN ARBOR, MI 48109-5867
Phone number:
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