Basic Information
| Provider Information | |||||||||
| NPI: | 1053428540 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NWOSU | ||||||||
| FirstName: | OGUCHI | ||||||||
| MiddleName: | ANDREW OSONDU | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., FAAFP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4500 N SHALLOWFORD RD | ||||||||
| Address2: | |||||||||
| City: | DUNWOODY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303386476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047786920 | ||||||||
| FaxNumber: | 4047786901 | ||||||||
| Practice Location | |||||||||
| Address1: | 4500 N SHALLOWFORD RD | ||||||||
| Address2: | |||||||||
| City: | DUNWOODY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303386476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047786920 | ||||||||
| FaxNumber: | 4047786901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 03/04/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 49072 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.