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Individual

MIKE W. OU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1125 E HIGHWAY 166, BOWDON, GA 30108-2401
(770) 258-5424
(770) 838-8980
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 836-9250
(770) 836-9261

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
053301
GA

Other

Enumeration date
07/04/2006
Last updated
06/18/2010
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