Provider Demographics
NPI:1407817091
Name:AGBEH, CEPHAS MAWUENA (MD)
Entity Type:Individual
Prefix:DR
First Name:CEPHAS
Middle Name:MAWUENA
Last Name:AGBEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6401 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4341
Mailing Address - Country:US
Mailing Address - Phone:736-572-5710
Mailing Address - Fax:763-571-3008
Practice Address - Street 1:4000 CENTRAL AVE NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-2968
Practice Address - Country:US
Practice Address - Phone:736-572-5710
Practice Address - Fax:763-782-8100
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN45505207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN365J2AGOtherBCBS NUMBER
MNHP38107OtherHEALTHPARTNERS
MN0704607OtherMEDICA NUMBER
MN1836742OtherAMERICA'S PPO
MN7007485OtherAETNA
MN172587OtherUCARE
MN0703414OtherMEDICA NUMBER
MN1034132OtherPREFERRED ONE
MN0703414OtherMEDICA NUMBER
MN172587OtherUCARE