Healthcare Provider Details

I. General information

NPI: 1740809276
Provider Name (Legal Business Name): AGATA MIGUT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14080 BOYS TOWN HOSPITAL RD
BOYS TOWN NE
68010-7513
US

IV. Provider business mailing address

14080 BOYS TOWN HOSPITAL RD
BOYS TOWN NE
68010-7513
US

V. Phone/Fax

Practice location:
  • Phone: 531-355-6509
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number37417
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: