# PRINCE GEORGES ENT HEAD & NECK SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prince Georges ENT Head & Neck Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992352033
- **Authorized official:** DR. BRYAN CHINAEMEREM EGO-OSUALA MD (PRESIDENT)
- **Authorized official phone:** (202) 999-8413

## Contact information

- **Practice address:** 10 SAINT PATRICKS DR, WALDORF, MD 20603-4527
- **Practice address phone:** (301) 373-7900
- **Practice address fax:** (301) 373-6900
- **Mailing address:** 1100 MERCANTILE LN STE 136, UPPR MARLBORO, MD 20774-5367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | Yes |
| 207Y00000X | Otolaryngology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/22/2019
- **Last updated:** 11/06/2020