Individual
DR. EZINMA EZEALAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2104A WOODRUFF RD, GREENVILLE, SC 29607-5941
(864) 336-2323
(864) 236-4222
Mailing address
2104A WOODRUFF RD, GREENVILLE, SC 29607-5941
(864) 336-2323
(864) 236-4222
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
MD37517
SC
207RR0500X
Rheumatology Physician
Primary
MD37517
SC
332900000X
Non-Pharmacy Dispensing Site
MD37517
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SC45168157
MEDICARE PTAN
SC
Enumeration date
06/03/2007
Last updated
02/07/2026
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