Basic Information
Provider Information
NPI: 1750385662
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: USIFO
FirstName: OSABUOHIEN
MiddleName: SUNDAY
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 106 E BROAD ST
Address2:  
City: SAVANNAH
State: GA
PostalCode: 314012917
CountryCode: US
TelephoneNumber: 9125271000
FaxNumber: 9125271155
Practice Location
Address1: 1170 SHAWNEE ST
Address2:  
City: SAVANNAH
State: GA
PostalCode: 314191618
CountryCode: US
TelephoneNumber: 9129200214
FaxNumber: 9129212004
Other Information
ProviderEnumerationDate: 06/08/2005
LastUpdateDate: 09/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X036472GAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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