Healthcare Provider Details

I. General information

NPI: 1609305655
Provider Name (Legal Business Name): SOCHIMA ISIOMA OCHIJE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 DALLAS HWY SW STE 310
MARIETTA GA
30064-7518
US

IV. Provider business mailing address

2655 DALLAS HWY SW STE 310
MARIETTA GA
30064-7518
US

V. Phone/Fax

Practice location:
  • Phone: 770-330-6193
  • Fax: 307-481-2634
Mailing address:
  • Phone: 770-330-6193
  • Fax: 307-481-2634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberW3169
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number89582
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number64356
License Number StateCT
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number89582
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: