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Individual

DR. EGHE EGIEBOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1418 COLLEGE DR, MOUNT CARMEL, IL 62863-2638
(618) 263-6302
Mailing address
PO BOX 68052, INDIANAPOLIS, IN 46268-0052

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036112265
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000207079
BLUE SHIELD
IN
01
000000225575
BLUE SHIELD
IN
01
000000240785
BLUE SHIELD
IN
05
200244860
IN
01
3932056
BLUE SHIELD
IL
Enumeration date
12/29/2005
Last updated
08/22/2023
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