Individual
COLLINS MBONU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(404) 686-4411
Mailing address
880 W PEACHTREE ST NW UNIT 2108, ATLANTA, GA 30309-2549
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
87271
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/17/2018
Last updated
10/11/2021
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