Individual
ONAJE DADISI GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 DIXIE ST, SUITE 401, CARROLLTON, GA 30117-3818
(770) 836-9326
(770) 836-9358
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 836-9326
(770) 836-9358
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
057079
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346632641G
—
GA
01
—
511I060280
MEDICARE PTAN
GA
Enumeration date
06/12/2006
Last updated
06/28/2010
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