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NPI Code Detail

MEDICARE: DR. ONWURA MICHAEL OBIEKWE MD

MEDICARE: DR. ONWURA MICHAEL OBIEKWE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician050236GA
2208M00000XHospitalist Physician50236GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972585446
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ONWURA MICHAEL OBIEKWE MD
Provider Business Mailing Address
First Line : 217 MEDICAL WAY
Second Line :
City : RIVERDALE
State : GA
Zip : 30274-2522
Country : US
Telephone Number : 770-991-9227
Fax Number : 770-996-0286
Provider Business Practice Location Address
First Line : 601 S 8TH ST
Second Line :
City : GRIFFIN
State : GA
Zip : 30224-4213
Country : US
Telephone Number : 770-467-6314
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 02/19/2021

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