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General NPI Number Information
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NPI Number | 1780497792
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Entity Type | Organization
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Legal Business Name | SUGAR PROS PC
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 5220 PARK AVE STE 202
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City | MEMPHIS
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State | TN
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Zip | 38119-3547
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Country | US
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Telephone | 901-468-3105
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Fax |
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Provider Business Mailing Address
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Address Line | 875 W POPLAR AVENUE, STE 24, #102
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City | COLLIERVILLE
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State | TN
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Zip | 38017
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CHERECHI OGWO
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Credential | M.D
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Telephone | 901-468-3105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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