Individual
DONATUS OGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
107 N SUMMEY ST, DALLAS, NC 28034-1824
(704) 923-0446
(704) 923-8319
Mailing address
PO BOX 578, DALLAS, NC 28034-0578
(704) 923-0446
(704) 923-8319
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9300555
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10826
BCBS
—
01
—
110159213
RAILROAD MEDICARE
—
01
—
116085
AETNA
—
01
—
1184723
CIGNA
—
01
—
21564
PARTNERS/PARTNERS MEDICAR
—
01
—
253704
MAMSI
—
01
—
441733
UNITED HEALTH CARE
—
01
—
76743
MEDCOST
—
05
—
8910826
—
NC
01
—
N0055C
SOUTH CAROLINA MEDICAID
—
Enumeration date
04/03/2006
Last updated
08/22/2008
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