=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649434952
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH METRO WOMENS'S HEALTHCARE P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/16/2008
-----------------------------------------------------
Last Update Date | 07/16/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601A PROFESSIONAL DR SUITE 290
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30045-3004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-338-8331
-----------------------------------------------------
Fax | 770-338-9499
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601A PROFESSIONAL DRIVE SUITE 290
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30045-3004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-338-8331
-----------------------------------------------------
Fax | 770-338-9499
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | DR. WILLIAM ODURO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 770-310-2343
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 52215
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------