De Sagun, Evangeline

De Sagun, Evangeline is an individual health care provider with primary practice located at 1221 S Gear Ave , West Burlington IA 52655-1679. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. De Sagun, Evangeline can be contacted via phone (319) 768-1000.

Contact Information

Primary practice address
1221 S Gear Ave West Burlington IA 52655-1679
Phone: (319) 768-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 036097387 Illinois

Profile Details

NPI number 1356446322
LBN Legal business name De Sagun, Evangeline
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Feb 9th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356446322 NPPES
Other 32913278 CHAMPUS
Other P00047449 CHAMPUS
Other 009847 CHAMPUS
Other 1922250 CHAMPUS
MEDICAID 036097387 CHAMPUS

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