Basic Information
| Provider Information | |||||||||
| NPI: | 1003801937 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZUA | ||||||||
| FirstName: | MENE | ||||||||
| MiddleName: | SUGAGE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1308 BRIARVILLE RD | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371155127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158683131 | ||||||||
| FaxNumber: | 6155150205 | ||||||||
| Practice Location | |||||||||
| Address1: | 1308 BRIARVILLE RD | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371155127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158683131 | ||||||||
| FaxNumber: | 6155150205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2005 | ||||||||
| LastUpdateDate: | 02/08/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 026535 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 3846536 | 05 | TN | MEDICAID |