Provider Demographics
NPI:1003224577
Name:OLEGHE, EFEWONGBE BENEDICTA
Entity Type:Individual
Prefix:MRS
First Name:EFEWONGBE
Middle Name:BENEDICTA
Last Name:OLEGHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 E 22ND STREET
Mailing Address - Street 2:ST VINCENT'S CHARITY MEDICAL CENTER
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115
Mailing Address - Country:US
Mailing Address - Phone:216-363-2725
Mailing Address - Fax:
Practice Address - Street 1:2351 E 22ND STREET
Practice Address - Street 2:ST VINCENT'S CHARITY MEDICAL CENTER
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115
Practice Address - Country:US
Practice Address - Phone:216-363-2725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.024120207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine