Organization
PRINCE GEORGES ENT HEAD & NECK SURGERY, LLC
Active
Other names
Prince Georges ENT Head & Neck Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN CHINAEMEREM EGO-OSUALA MD (PRESIDENT)
(202) 999-8413
Entity
Organization
Contact information
Practice address
10 SAINT PATRICKS DR, WALDORF, MD 20603-4527
(301) 373-7900
(301) 373-6900
Mailing address
1100 MERCANTILE LN STE 136, UPPR MARLBORO, MD 20774-5367
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
08/22/2019
Last updated
11/06/2020
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