Healthcare Provider Details

I. General information

NPI: 1770997835
Provider Name (Legal Business Name): OSCAR MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 07/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 MEMORIAL DR
DECATUR GA
30032-2706
US

IV. Provider business mailing address

3055 OAK HAMPTON WAY
DULUTH GA
30096-5855
US

V. Phone/Fax

Practice location:
  • Phone: 470-355-2340
  • Fax: 470-355-2347
Mailing address:
  • Phone: 470-355-2340
  • Fax: 470-355-2347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number039650
License Number StateGA

VIII. Authorized Official

Name: DR. IGWEBUIKE ONYEKABA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 470-355-2340