Provider Demographics
NPI:1932118312
Name:MAGANA, ARMANDO J (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMANDO
Middle Name:J
Last Name:MAGANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 AVENUE B
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4617
Mailing Address - Country:US
Mailing Address - Phone:308-630-2100
Mailing Address - Fax:308-630-2139
Practice Address - Street 1:3911 AVENUE B
Practice Address - Street 2:SUITE 1100
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4617
Practice Address - Country:US
Practice Address - Phone:308-630-2100
Practice Address - Fax:308-630-2139
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17252207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE513889513Medicaid
110106403OtherPALMENTO GBA RR MEDICARE
110106403OtherPALMENTO GBA RR MEDICARE
NE513889513Medicaid
NE266008MAMedicare ID - Type UnspecifiedMEDICARE