Healthcare Provider Details

I. General information

NPI: 1912842022
Provider Name (Legal Business Name): MAAME EFUA ESIBUABA VANESSA SERSAH MBCHB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MADISON AVENUE SUITE 447
MEMPHIS TN
38103
US

IV. Provider business mailing address

50 NORTH DUNLAP STREET 6TH FLOOR RESEARCH CENTER
MEMPHIS TN
38103
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-6756
  • Fax:
Mailing address:
  • Phone: 901-287-6756
  • Fax: 901-287-4581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: