Individual
DR. OSMUND UGOCHUKWU AGBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025
(347) 804-9172
Mailing address
1073 SING SING RD, APT. C1, HORSEHEADS, NY 14845-1389
(469) 417-7569
(877) 929-4871
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
N2359
TX
207R00000X
Internal Medicine Physician
45748
KY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
200701973
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
251622
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
N2359
TX
207RP1001X
Pulmonary Disease Physician
Primary
200701973
NC
207RP1001X
Pulmonary Disease Physician
251622
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5921995
—
NC
01
—
NCA103A
MEDICARE PTAN, INDIVIDUAL FOR CMC-NORTHEAST
NC
Enumeration date
09/10/2007
Last updated
03/14/2023
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