Provider Demographics
NPI:1679345227
Name:OJO, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:OJO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 BROWNING BEND CT
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7764
Mailing Address - Country:US
Mailing Address - Phone:862-224-0307
Mailing Address - Fax:
Practice Address - Street 1:2020 BROWNING BEND CT
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7764
Practice Address - Country:US
Practice Address - Phone:862-224-0307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)