Provider Demographics
NPI:1538459292
Name:ESIN, ESHAMUMERENE (MD)
Entity Type:Individual
Prefix:DR
First Name:ESHAMUMERENE
Middle Name:
Last Name:ESIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4815 ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2705
Mailing Address - Country:US
Mailing Address - Phone:915-544-1200
Mailing Address - Fax:
Practice Address - Street 1:3707 LARGENT WAY NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-5981
Practice Address - Country:US
Practice Address - Phone:678-581-5729
Practice Address - Fax:678-581-5835
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD20140703207Q00000X
GA77256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine