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General NPI Number Information
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NPI Number | 1194454975
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Entity Type | Individual
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Provider Name | DARNELLE AMBO MD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 2258 WRIGHTSBORO RD STE 300
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City | AUGUSTA
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State | GA
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Zip | 30904-4788
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Country | US
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Telephone | 706-792-5075
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Fax | 706-230-1476
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Provider Business Mailing Address
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Address Line | 63 W CANDLER ST
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City | WINDER
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State | GA
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Zip | 30680-2558
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Country | US
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Telephone | 470-499-0715
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Fax | 706-230-1476
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 102242
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License Number State | GA
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