Healthcare Provider Details

I. General information

NPI: 1609184506
Provider Name (Legal Business Name): DANIEL ABOYAWOH NJINGEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 NORTH 3RD STREET
BRAINERD MN
56401-3054
US

IV. Provider business mailing address

2400 S. MINNESOTA AVE. STE. 100
SIOUX FALLS SD
57105-3762
US

V. Phone/Fax

Practice location:
  • Phone: 218-829-2861
  • Fax:
Mailing address:
  • Phone: 605-322-7510
  • Fax: 605-322-6475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number62889
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number339484
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number8799
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: