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General NPI Number Information
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NPI Number | 1083839393
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Entity Type | Individual
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Provider Name | CLEMENT ANYANWU M.D
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Gender | Male
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 1459 LANEY WALKER BLVD
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City | AUGUSTA
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State | GA
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Zip | 30912-0002
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Country | US
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Telephone | 721-706-3157
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Fax |
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Provider Business Mailing Address
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Address Line | 950 STEVENS CREEK RD APT A1
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City | AUGUSTA
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State | GA
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Zip | 30907-3249
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Country | US
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Telephone | 732-682-8521
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | P0001
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 001759
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License Number State | GA
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