Healthcare Provider Details

I. General information

NPI: 1417453135
Provider Name (Legal Business Name): CHRISTOPHER UZOCHUKWU ESONU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 EAGLES LANDING PKWY
STOCKBRIDGE GA
30281-5085
US

IV. Provider business mailing address

PO BOX 1360
POOLER GA
31322-1276
US

V. Phone/Fax

Practice location:
  • Phone: 678-604-5901
  • Fax:
Mailing address:
  • Phone: 240-441-6878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number92759
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number92759
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: