| Ezugha Pediatric Neurology And Associates Pc | |
|
2500 Wigwam Pkwy Ste 111 Henderson NV 89074-7113 | |
| (702) 852-1155 | |
| Not Available |
| Full Name | Ezugha Pediatric Neurology And Associates Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2500 Wigwam Pkwy Ste 111, Henderson, Nevada |
| Authorized Official Name and Position | Herbert Ezugha (OWNER) |
| Authorized Official Contact | 4077755035 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ezugha Pediatric Neurology And Associates Pc 2500 Wigwam Pkwy Ste 111 Henderson NV 89074-7113 Ph: (702) 852-1155 | Ezugha Pediatric Neurology And Associates Pc 2500 Wigwam Pkwy Ste 111 Henderson NV 89074-7113 Ph: (702) 852-1155 |
| NPI Number | 1184270258 |
|---|---|
| Provider Enumeration Date | 08/14/2019 |
| Last Update Date | 08/14/2019 |
| Medicare PECOS PAC ID | 0749511764 |
|---|---|
| Medicare Enrollment ID | O20191004002993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184270258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | (* (Not Available)) | Primary |
| Provider Name | Herbert Osita Ezugha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871758649 PECOS PAC ID: 6305018417 Enrollment ID: I20191004003074 |
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