Provider Demographics
NPI:1699762419
Name:EGBE, PATRICK A (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:A
Last Name:EGBE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3333 JODECO ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253
Mailing Address - Country:US
Mailing Address - Phone:770-692-4000
Mailing Address - Fax:770-474-8510
Practice Address - Street 1:3333 JODECO ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253
Practice Address - Country:US
Practice Address - Phone:770-692-4000
Practice Address - Fax:770-474-8510
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2024-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA033571207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000439425DMedicaid
GA000439425DMedicaid
GAE47509Medicare UPIN