Organization
AMBROSIA FUNCTIONAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHIBUZOR STEVE EKE FNP-C (MANAGING PARTNER)
(404) 585-4964
Entity
Organization
Contact information
Practice address
1668 MULKEY RD STE G, AUSTELL, GA 30106-1163
(404) 585-4964
(404) 581-5838
Mailing address
5878 GRAYWOOD CIR SE, MABLETON, GA 30126-2894
(404) 585-4964
(404) 581-5838
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134670474
—
GA
Enumeration date
11/27/2021
Last updated
03/17/2025
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