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General NPI Number Information
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NPI Number | 1619443728
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Entity Type | Individual
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Provider Name | OLAOCHA BEATRICE OKWUADIGBO MD
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Gender | Female
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Dates
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Enumeration Date | 10/16/2018
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 155 WESTRIDGE PKWY STE 221
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City | MCDONOUGH
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State | GA
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Zip | 30253-3052
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Country | US
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Telephone | 703-403-2505
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 LAKE ERMA DR
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City | HAMPTON
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State | GA
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Zip | 30228-6083
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Country | US
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Telephone | 703-403-2505
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Fax | 855-874-4592
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME149581
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | TRN27866
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 93536
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License Number State | GA
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