Healthcare Provider Details

I. General information

NPI: 1053094847
Provider Name (Legal Business Name): TOCHUKWU TOBIAS EGBUJIOBI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 US HIGHWAY 280 W
AMERICUS GA
31719-8645
US

IV. Provider business mailing address

701 PARK AVE
MINNEAPOLIS MN
55415-1623
US

V. Phone/Fax

Practice location:
  • Phone: 229-924-6011
  • Fax:
Mailing address:
  • Phone: 612-873-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number114240
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: