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General NPI Number Information
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NPI Number | 1669663365
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Entity Type | Organization
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Legal Business Name | CENTER OF HOPE FOR CANCERS AND BLOOD DISORDERS
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 7444 HANNOVER PKWY SUITE 150
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City | STOCKBRIDGE
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State | GA
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Zip | 30281
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Country | US
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Telephone | 770-629-2337
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Fax | 770-629-5194
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Provider Business Mailing Address
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Address Line | P.O. BOX 1710
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City | STOCKBRIDGE
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State | GA
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Zip | 30281
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Country | US
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Telephone | 770-629-2337
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Fax | 770-629-5194
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ANTHONY C ONYEGBULA
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Credential | D.O.
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Telephone | 770-629-2337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 053348
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License Number State | GA
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