Individual
CHIAZOM C OMERUAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1240 EAGLES LANDING PKWY STE 110, STOCKBRIDGE, GA 30281-5173
(770) 389-3855
(770) 474-8078
Mailing address
1240 EAGLES LANDING PKWY STE 110, STOCKBRIDGE, GA 30281-5173
(770) 389-3855
(770) 474-8078
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
75091
GA
207Q00000X
Family Medicine Physician
DO.1225
AL
207Q00000X
Family Medicine Physician
OS015547
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133889
—
AL
01
—
2984309
CIGNA
AL
01
—
511-18690
BCBS
AL
01
—
Z40098
VIVA HEALTH
AL
Enumeration date
08/01/2008
Last updated
03/27/2018
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