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General NPI Number Information
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NPI Number | 1396240156
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Entity Type | Individual
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Provider Name | ERNEST SETH EGU MD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 800 COOPER ST FL 4
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City | CAMDEN
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State | NJ
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Zip | 08102-1155
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Country | US
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Telephone | 856-342-3040
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Fax |
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Provider Business Mailing Address
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Address Line | 800 COOPER ST FL 4
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City | CAMDEN
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State | NJ
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Zip | 08102-1155
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Country | US
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Telephone | 856-342-3040
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 25MA11426800
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License Number State | NJ
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