Provider Demographics
NPI:1053428540
Name:NWOSU, OGUCHI ANDREW OSONDU (MD, FAAFP)
Entity type:Individual
Prefix:DR
First Name:OGUCHI
Middle Name:ANDREW OSONDU
Last Name:NWOSU
Suffix:
Gender:M
Credentials:MD, FAAFP
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Mailing Address - Street 1:4500 N SHALLOWFORD RD
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6476
Mailing Address - Country:US
Mailing Address - Phone:404-778-6920
Mailing Address - Fax:404-778-6901
Practice Address - Street 1:4500 N SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6476
Practice Address - Country:US
Practice Address - Phone:404-778-6920
Practice Address - Fax:404-778-6901
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA49072207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine