Organization
FIRST FOUNDATION CLINIC OF THE CAROLINAS CHARLOTTE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONATUS O OGU MD (PRESIDENT)
(704) 866-4607
Entity
Organization
Contact information
Practice address
4938 CENTRAL AVE, CHARLOTTE, NC 28205-5871
(704) 567-0465
(704) 567-2940
Mailing address
PO BOX 471279, CHARLOTTE, NC 28247-1279
(704) 567-0465
(704) 567-2940
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89016H3
—
NC
Enumeration date
04/03/2006
Last updated
09/28/2009
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