MEDICARE: DR. OSEMWEGIE EMMANUEL EMOVON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	22793	SC

General Provider Information

NPI Number	:	1285684548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OSEMWEGIE EMMANUEL EMOVON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 81113
Second Line	:	ASHLEY RIVER STATION
City	:	CHARLESTON
State	:	SC
Zip	:	29416-1113
Country	:	US
Telephone Number	:	843-573-0499
Fax Number	:	843-573-2463

Provider Business Practice Location Address
First Line	:	1007 PHYSICIANS DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5746
Country	:	US
Telephone Number	:	843-573-0499
Fax Number	:	843-573-2463

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	04/13/2026

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