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Individual

DR. SYLVESTER IZUCHUKWU OGBATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 MEDFORD DR, CHARLOTTE, NC 28205-5624
(704) 940-5588
(704) 940-5589
Mailing address
7619 BERRYFIELD CT, WAXHAW, NC 28173-9817
(203) 545-9119
(704) 940-5589

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200401554
NC
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
200401554
NC
207RN0300X
Nephrology Physician
Primary
200401554
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5900398
NC
05
N01554
SC
Enumeration date
03/22/2006
Last updated
09/23/2021
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