Individual
IZIEN IRUOBE IMOUKHUEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 CHARTER BLVD STE 402, MACON, GA 31210-0722
(478) 757-6400
Mailing address
9710 STATE AVE, MARYSVILLE, WA 98270-2232
(360) 653-1742
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
104101
GA
Other
Enumeration date
07/19/2022
Last updated
10/22/2025
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