Ezenwa, Basil
Ezenwa, Basil is an sole proprietor health care provider with primary practice located at 616 19Th St , Columbus GA 31901-1528. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Ezenwa, Basil can be contacted via phone (904) 805-1300.Contact Information
Primary practice address
616 19Th St
Columbus GA 31901-1528
Phone: (904) 805-1300
Fax: (904) 805-1302
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 37797 | Georgia |
Profile Details
| NPI number | 1942244280 |
|---|---|
| LBN Legal business name | Ezenwa, Basil |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2006 |
| Last updated | Mar 19th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942244280 | NPPES |
| Alabama | MEDICAID | 009922855 | |
| Alabama | MEDICAID | 000580082D | |
| Alabama | Other | 616430 |
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