Physician Compare National (NPI:1912325176)

HEALTHCARE PROVIDER: BRENDA NYAMOGO 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	1912325176
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9436376530
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170726000289
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NYAMOGO
	Individual professional last name
Provider First Name	BRENDA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	522 E MAIN ST
	Group Practice or individual's line 1 address
City	FARWELL
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	486229118
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	010001
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHEAST ALABAMA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230180
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MIDMICHIGAN MEDICAL CENTER-CLARE
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230080
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MCLAREN CENTRAL MICHIGAN
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	010036
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ANDALUSIA REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	010007
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	MIZELL MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	M

Physician Compare National (NPI:1912325176)

HEALTHCARE PROVIDER: BRENDA NYAMOGO MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information