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Organization
J-RAPHA CLINIC LLC
Active
Organization
J-RAPHA CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONATUS M EGBONIM MD (OWNER)
(803) 433-7991
Entity
Organization
Contact information
Practice address
1042 PROFESSIONAL COURT, MANNING, SC 29102-2827
(803) 433-7991
(803) 433-7791
Mailing address
1042 PROFESSIONAL COURT, MANNING, SC 29102-2827
(803) 433-7991
(803) 433-7791
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20233
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0116367
GHI
SC
01
—
20049632
SELECT HEALTH FIRST CHOICE
SC
05
—
202337
—
SC
01
—
P00423235
RAILROAD MEDICARE
SC
Enumeration date
06/14/2007
Last updated
05/06/2008
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