Provider Demographics
NPI:1891221123
Name:AGABA, COMFORT (MD)
Entity Type:Individual
Prefix:DR
First Name:COMFORT
Middle Name:
Last Name:AGABA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:COMFORT
Other - Middle Name:
Other - Last Name:AGABA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1325 S CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1007
Mailing Address - Country:US
Mailing Address - Phone:605-322-6408
Mailing Address - Fax:605-322-4995
Practice Address - Street 1:1325 S CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1007
Practice Address - Country:US
Practice Address - Phone:605-322-6408
Practice Address - Fax:605-322-4995
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD12141207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine