EDEM S AGAMAH (NPI# 1932147279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932147279 |
| Entity Type | Individual |
| Full Name | EDEM S AGAMAH |
| Credential | MD |
| Practice Address |
315 W Carpenter St 1st Floor, Clinic B Springfield IL 62702-4901 |
| Mailing Address |
315 W Carpenter St Po Box 19678 Springfield IL 62702-4901 |
| Practice Telephone | 2175458000 |
| Practice Fax Number | 2175451141 |
| Mailing Telephone | 2175458000 |
| Mailing Fax Number | 2175451141 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
036085000 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036085000 | 05 | |
| IL | RAILROAD MEDICARE | 900001174 | 01 |
| IL | HEALTHLINK | 272742 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 8415062 | 01 |
| Street Address |
315 W CARPENTER ST 1ST FLOOR, CLINIC B |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-4901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457348401 | Jan Rakinic | Colon & Rectal Surgery | 315 W Carpenter St, 2nd Floor, Springfield, IL 62702-4901 | 2005-10-04 |
| 1124634290 | Amanda C Lee | Nurse Practitioner | 315 W Carpenter St, Springfield, IL 62702-4901 | 2020-09-23 |
| 1255703971 | Michelle C Gates | Psychologist | 315 W Carpenter St, 1st Floor, Clinic A, Springfield, IL 62702-4901 | 2015-10-21 |
| 1639561285 | Jessica Dour | Nurse Practitioner | 315 W Carpenter St, 2nd Floor, Clinic C, Springfield, IL 62702-4901 | 2015-02-19 |
| 1629499769 | Patricia Marie Fank | Psychologist | 315 W Carpenter St, 1st Floor, Springfield, IL 62702-4901 | 2013-12-16 |
| 1376977371 | Anita D. Schwab | Nurse Practitioner | 315 W Carpenter St, 1st Floor, Springfield, IL 62702-4901 | 2013-08-26 |
| 1376881136 | Dodie Gazda | Nurse Practitioner | 315 W Carpenter St, Clinic B, Springfield, IL 62702-4901 | 2013-01-29 |
| 1083962583 | Emily S Lane | Social Worker | 315 W Carpenter St, 3rd Floor, Springfield, IL 62702-4901 | 2012-08-15 |
| 1265792196 | Kyungsuk Jung | Internal Medicine | 315 W Carpenter St, Clinic B, Springfield, IL 62702 | 2012-05-25 |
| 1215205109 | Shelda Iverson Borders | Psychologist | 315 W Carpenter St, 3rd Floor, Springfield, IL 62702-4901 | 2011-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700071008 | Shravan Kumar Narmala | Internal Medicine | 2055 S Fremont Ave Ste 1000, Springfield, MO 65804-2206 | 2007-09-10 |
| 1356447288 | John Thomas Fitzharris | Internal Medicine | 3377 Riverbend Dr Ste 500, Springfield, OR 97477-8802 | 2006-09-16 |
| 1881637049 | Namita Vinayek | Internal Medicine | 900 N 1st Street, Springfield, IL 62702 | 2006-06-14 |
| 1285692178 | Tennessee Oncology Pllc | Internal Medicine | 480 Northcrest Dr, Ste 400, Springfield, TN 37172-3972 | 2006-05-02 |
| 1801879762 | Timothy A Johnson | Internal Medicine | 271 Carew Street, Springfield, MA 01104 | 2005-11-23 |
| 1609865294 | Meghna Ramesh Desai | Internal Medicine | 315 W Carpenter St Fl 1, Springfield, IL 62702-4901 | 2005-10-17 |
| 1235128109 | Krishna A Rao | Internal Medicine | 415 N 9th St, Springfield, IL 62702-5317 | 2005-10-13 |
| 1285232140 | Daniella Greaves | Internal Medicine | 385 Morris Ave, Springfield, NJ 07081-1151 | 2020-10-13 |
| 1932645744 | Lester E Cox Medical Centers | Internal Medicine | 3850 S National Ave, Springfield, MO 65807-5287 | 2017-01-18 |
| 1477908788 | Effingham Physician Practices, LLC | Internal Medicine | 459 Hwy 119 S, Ste B, Springfield, GA 31329-3021 | 2016-04-25 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on EDEM S AGAMAH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.