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General NPI Number Information
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NPI Number | 1245640820
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Entity Type | Individual
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Provider Name | EFOSA OMONUWA OGIAMIEN MD
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Gender | Male
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1370 MONTREAL RD STE 130
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City | TUCKER
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State | GA
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Zip | 30084-8128
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Country | US
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Telephone | 601-613-8250
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Fax |
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Provider Business Mailing Address
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Address Line | 3390 PEACHTREE RD NE STE 1500
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City | ATLANTA
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State | GA
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Zip | 30326-2822
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Country | US
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Telephone | 404-920-4950
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Fax | 404-920-4959
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 82884
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 37064
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 82884
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 82884
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License Number State | GA
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