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Individual

OSARENOMASE EGHAREVBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1412 MILSTEAD AVE NE, CONYERS, GA 30012-3877
(770) 918-3000
Mailing address
2801 DEKALB MEDICAL PKWY, LITHONIA, GA 30058-4996
(404) 501-8492

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
78620
GA
208M00000X
Hospitalist Physician
4301108530
MI
208M00000X
Hospitalist Physician
78620
GA

Other

Enumeration date
03/26/2011
Last updated
12/23/2022
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