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General NPI Number Information
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NPI Number | 1972585446
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Entity Type | Individual
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Provider Name | ONWURA MICHAEL OBIEKWE MD
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Gender | Male
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 601 S 8TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-4213
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Country | US
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Telephone | 770-467-6314
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Fax |
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Provider Business Mailing Address
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Address Line | 217 MEDICAL WAY
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City | RIVERDALE
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State | GA
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Zip | 30274-2522
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Country | US
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Telephone | 770-991-9227
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Fax | 770-996-0286
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 050236
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 50236
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License Number State | GA
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