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Individual

CHARLES N. OKOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1151 CLEVELAND AVE, SUITE D, EAST POINT, GA 30344-3600
(404) 761-7949
(404) 761-7386
Mailing address
1151 CLEVELAND AVE, SUITE D, EAST POINT, GA 30344-3600
(404) 761-7949
(404) 761-7386

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
048686
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000893483C
GA
01
20-0235522
TAX ID
GA
Enumeration date
01/30/2006
Last updated
01/05/2011
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