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General NPI Number Information
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NPI Number | 1740468016
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Entity Type | Organization
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Legal Business Name | METRO INFECTIOUS DISEASE ASSOCIATES, INC
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 1413 CLEVELAND AVE
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City | EAST POINT
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State | GA
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Zip | 30344-6901
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Country | US
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Telephone | 404-768-2669
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Fax | 404-768-3479
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Provider Business Mailing Address
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Address Line | 1413 CLEVELAND AVE
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City | EAST POINT
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State | GA
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Zip | 30344-6901
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Country | US
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Telephone | 404-768-2669
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Fax | 404-768-3479
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Authorized Official
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Title or Position | OWNER
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Name | DR. OVIE E UGHWANOGHO
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Credential | MD
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Telephone | 404-768-2669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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