Individual
DR. BRYAN C. EGO-OSUALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 SAINT PATRICKS DR, WALDORF, MD 20603-4527
(301) 373-7900
(301) 373-6900
Mailing address
10 SAINT PATRICKS DR, WALDORF, MD 20603-4527
(301) 373-7900
(301) 373-6900
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
2014-00330
NC
207Y00000X
Otolaryngology Physician
Primary
D71707
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1046720
WELLCARE OF SC
SC
01
—
1479753
AETNA/COVENTRY
—
01
—
187LA
BCBSNC
NC
05
—
331216000
—
MD
01
—
6079386
CIGNA
—
01
—
NC2120
MEDICAID - SC
SC
01
—
P01671244
RAILROAD MEDICARE
NC
Enumeration date
03/14/2007
Last updated
12/08/2021
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