Individual
LIBERTY ODINAMADU UBANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGANCP-BC
Contact information
Practice address
1272 MARLTON CHASE DR, LAWRENCEVILLE, GA 30044-2011
(404) 966-9572
Mailing address
1272 MARLTON CHASE DR, LAWRENCEVILLE, GA 30044-2011
(404) 966-9572
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
RN221108
GA
363LA2100X
Acute Care Nurse Practitioner
RN221108
GA
Other
Enumeration date
04/22/2021
Last updated
12/11/2023
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