Organization
EGUOSA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EGUNMWENDIA OGBEIDE MD (PRESIDENT)
(901) 377-7308
Entity
Organization
Contact information
Practice address
1300 WESLEY DR, MEMPHIS, TN 38116-6426
(901) 516-3700
Mailing address
PO BOX 1891, COLLIERVILLE, TN 38027-1891
(901) 516-3700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
TN
207RX0202X
Medical Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q02814
—
TN
Enumeration date
05/11/2017
Last updated
09/06/2017
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