Physician Compare National (NPI:1902802515)

HEALTHCARE PROVIDER: PRINCEWILL U EHIRIM MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1902802515
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224107941
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080521000595
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EHIRIM
	Individual professional last name
Provider First Name	PRINCEWILL
	Individual professional first name
Provider Middle Name	U
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	NEUROSURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	601 A PROFESSIONAL DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 210
	Group Practice or individual's line 2 address
City	LAWRENCEVILLE
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	300463325
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110192
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	EASTSIDE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110087
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GWINNETT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y