Provider Demographics
NPI:1003801937
Name:ZUA, MENE SUGAGE (MD)
Entity Type:Individual
Prefix:DR
First Name:MENE
Middle Name:SUGAGE
Last Name:ZUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 BRIARVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5127
Mailing Address - Country:US
Mailing Address - Phone:615-868-3131
Mailing Address - Fax:615-515-0205
Practice Address - Street 1:1308 BRIARVILLE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5127
Practice Address - Country:US
Practice Address - Phone:615-868-3131
Practice Address - Fax:615-515-0205
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN026535207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3846536Medicaid
TN3846536Medicaid
G11402Medicare UPIN