Basic Information
| Provider Information | |||||||||
| NPI: | 1760617641 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IYEGHA | ||||||||
| FirstName: | UROGHUPATEI | ||||||||
| MiddleName: | PAUL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8170 33RD AVE S # MS 21110Q | ||||||||
| Address2: | |||||||||
| City: | BLOOMINGTON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554254516 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 420 DELAWARE ST SE | ||||||||
| Address2: | MAYO MAIL CODE 195 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554550341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126251400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2009 | ||||||||
| LastUpdateDate: | 12/06/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0127X | 52798 | MN | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | 52798 | MN | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.