Nwosu, Marjorie Mabong

Nwosu, Marjorie Mabong is an individual health care provider with primary practice located at 3505 Broadway , Mount Vernon IL 62864. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Nwosu, Marjorie Mabong can be contacted via phone (618) 242-3495.

Contact Information

Primary practice address
3505 Broadway Mount Vernon IL 62864
Phone: (618) 242-3495
Fax: (618) 241-8775
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301068282 Michigan

Profile Details

NPI number 1932164951
LBN Legal business name Nwosu, Marjorie Mabong
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated May 23rd, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932164951 NPPES
Other P00792826 RR INDIVIDUAL #
MEDICAID 1932164951 RR INDIVIDUAL #
Other 833230 RR INDIVIDUAL #
Other 35-0-41-0927-2 RR INDIVIDUAL #
Other CA2182 RR INDIVIDUAL #

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